Mills Act Contract Application (revised 7/2019) 2
5. Is the property listed on the Glendale Register of Historic Resources? Yes ___________ No ___ ________ ______
6. Work Plan. List any proposed or anticipated work that will be done to the property over the next ten years.
For example: 2011 - new roof; 2011 - upgrade electrical. (Attach a separate page, if necessary) All Property Owners MUST Sign This Application:
1. _ _______________________________ 2. ______________________________________ Please Print
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P ure/s
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Property Owne Please Print
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Date Date
3. ___________________________________________________ 4. ___________________________________________________ Please Print Please Print
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___________________________________________________ ___________________________________________________ Date Date
FOR STAFF USE ONLY
Date received in Permit Services Center ___________________ Received by ____________ Date Stamp Fee paid _______________ Receipt No. _________________