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2. I hereby request partial exemption from real estate taxes for qualifying property to be rehabilitated as provided by County Ordinance Section 9-14.3 of the Campbell County Code.*

   1. I agree.
4. Owner Name*
6. Property Location*
8. Parcel ID
9. Year Built*
11. Estimated Cost of Work*
13. Description of Work to Be Completed*
15. Copy of Appropriate Building Permit Attached*
17. Mailing Address*
19. City*
20. State*
21. Zip Code*
23. Phone*
24. Email*
28. Commercial or Industrial Application Fee - $100*

    1. Check, cash or credit card

    Please note: This form serves as a preliminary application upon receipt. Application is not complete until payment is collected. Payment Options: Checks may be mailed to Campbell County Real Estate; cash or credit card may be paid in person at Campbell County's Real Estate or Community Development Offices.

30. I certify that the statements contained in this application are to the best of my knowledge both correct and true and that I have received a copy of the aforementioned ordinance. I have reviewed and understand the requirements of the program.*

    1. I agree.
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41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field