Please complete all of the information about the housing unit listed below.
**If all units at this location do not have the same number of bedrooms, please complete a separate form for each unit.
Size of Unit
Indicate whether the owner or tenant is responsible for the following utilities
The unit is heated with
The stove uses
The hot water is heated with
Describe the overall quality and condition of the unit in comparison with other apartments you have seen.
Estimated year of construction or last major renovation
Check all boxes that apply if the unit has specific features to assist people with the following types of disabilities
Check all boxes that apply