Site Address __________________________ Folio #35-00-_____ _________

Current Business Name if applicable ________________________________

Present Property Owner(s)______________________________________

Owners’ Address _________________________________ Phone __________

If resale, name of buyer(s) __________________________________________

If lease, name of lessee(s) ___________________________________________

Lessee’s Address _______________________________ Phone _____________

Give brief description of the premises______________________________________________

___________________________________________________________________________
**Attach property fact / sales sheet.

Please circle zoning district: R-1 R-2 R-3 R-4 R-5 R–6 B LI POC

Has this property ever been granted a Variance by the Zoning Hearing Board? If so, attach copy of Order.

Does this property currently have a legal non-conforming use? If so, attach note describing same. Note date first used in this manner.

What is the proposed use for this property? (Note use of each level.)

Using the Use #’s / Codes defined in Section 1256.04 "Use Definitions and Standards" click here for chart of the Zoning Code, give use codes for proposed use. (check on line Codified Ordinances for appropriate Code Section )click here to link to 1256.04

Primary Use _______________ Secondary Use ___________
Bsmt ________ 1st Floor ___________ 2nd Floor _________ 3rd Floor ________

# of Apartments @ this site ______ Current year registration paid on ______

***Please note, YOU must call Greg Lebold @ 610-543-5229 to set up appointment.***

IF THE PROPERTY FAILS INSPECTION, A RE INSPECTION IS REQUIRED TO BE APPLIED FOR, PAID FOR, SCHEDULED & COMPLETED PRIOR TO THE ISSUANCE OF A U & O CERTIFICATE. THE RE-INSPECTION FEE IS THE SAME AS THE INITIAL FEE.

Applicant _____________________ Phone ____________ Settlement __________

Current Fees: Res = $75  Comm = $150 Apt = $50, then $20 Office Suite $75  then $50 each succeeding unit

-------------------------------------------------------FOR OFFICE USE ONLY -------------------------------------------------------

Application Date _______________ Fee ____________ Check # ___________ (last revised 5-8-02 cmtm)
Inspection Day __________ Date ___________ Time ____________
Inspector ______________ Inspection Passed or Failed

Re-inspection Application Date __________ Fee ________ Check # ________
Re-inspection Day __________ Date ___________ Time ____________
Inspector ______________ Re- inspection Passed or Failed