Vacant Building Program Supplemental Application (Complete in addition to Application) Name of Applicant: Web site Address: PLEASE ANSWER QUESTIONS—IF THEY DO NOT APPLY, INDICATE APPLICABLE” “NOT 1. Building Information: Location No. of Vacant Location Address Construction Age No. Stories 1 2 3 Utilities that are still turned on: Location Prior Occupancy Gas Electric Water No. 1 2 3 Area Occupied Location Vacant Use or Leased To Footage No. Area (sq. ft.) Others (sq. ft.) 1 2 3 2. Building Security/Neighborhood: Neighborhood Building Security (“x” those applicable) (“x” those applicable) Location Fully Guarded How often do you Boarded Fenced Alarmed Rural No. Locked 24-Hours see the building? 1 2 3 3. Plans For The Building(s):
Vacant Building Program Supplemental Application (Complete in addition to Application) Name of Applicant: Web site Address: PLEASE ANSWER QUESTIONS—IF THEY DO NOT APPLY, INDICATE “NOT APPLICABLE” 1. Building Information: Location No. Location Address Construction Age No. of Stories Vacant 1 2 3 Utilities that are still turned on: Location No. Prior Occupancy Gas Electric Water 1 2 3 Location No. Use Vacant Area (sq. ft.) Area Occupied or Leased To Others (sq. ft.) Footage 1 2 3 2. Building Security/Neighborhood: Building Security (“x” those applicable) Neighborhood (“x” those applicable) Location No. Boarded Fully Locked Fenced Guarded 24-Hours Alarmed How often do you see the building? Rural 1 2 3 3. Plans For The Building(s):
VacantBuildingPropertyCoverage-Sup.docx