Welcome to Baltimore Housing

Community Managed Open Space License Request Form

Ready to Adopt-A-Lot? Please fill out and submit the form to get started...

Contact Information

Applicant Name*
this response is the name the license will be issued in

Contact Person*

Contact Mailing Address*

Contact Mailing City*

Contact Mailing State*

Contact Mailing Zip*

Email Address*

Verify Email Address*

Phone Number*

Lot Information

Requested Addresses*
(if it is a descriptive lot, please put the block and lot number) 1.
2.
3.
4.
5.
6.

Brief description of your project*

Proposed Use* 1. Clean and Green
2. Flower Garden

3. Are You Growing Food? YesNo

If yes, is food production the primary use of the lot? YesNo

4. Other:

Has this green space been in existence for at least 2.5 years? YesNo

Is there an identified site manager/steward? YesNo

Is there an existing Adopt A Lot license? YesNo

Does it serve a community purpose? YesNo If yes, what

If you’ve answered yes to all of these questions, are you interested in having this site classified as a Qualified Community-Managed Open Space (QCMOS)? YesNo

Renewal Information

Is this a renewal? YesNo

If so, did you receive any grants for the garden within the last 12 months? YesNo

If so, how much did you receive to invest in the garden?

Water Access Information Would you like to use the information in this application to also apply for access to City water? If so, when you send back your executed agreement you will need to send back the required payment of $120.00. If not, when you need water you will need to complete a water access license application Yes
No, I do not need access to City water
No, I will apply at a later time

The Bureau of Water and Wastewater reserves the right to notify DHCD that water supply will be discontinued within five business days from notice of abuse or misuse at the location previously authorized.

* denotes required field