Rev 4/2009
BENSALEM TOWNSHIP
Permit #
Date
Tax Parcel #
APPLICATION FOR HOME OCCUPATION
Applicant’s Signature Date
BUSINESS INFORMATION
Name of Business:
Description of Business:
Square Footage or Percent of Residence that the Business Occupies:
Type of Equipment to be Used:
Will There Be Any Alterations to the Structure? (Addition, or Removal of Walls, Electric, Plumbing) YES NO
If yes, please explain:
SITE INFORMATION
MUST SUBMIT FLOOR PLAN OF BUILDING INDICATING LOCATION AND DIMENSIONS OF HOME OCCUPATION
Location of Subject Property
Phone Number
Email Address
Tax Parcel Number
Zoning District
Signature of Applicant Date Printed Name
FOR OFFICE USE ONLY
Zoning Officer’s Decision
Inspection Date:
Approved Denied Pursuant to Section:
Code of the Township of Bensalem
Zoning Officer Signature Date
Township of Bensalem Building & Planning Dept. Fee: $ Date Received:
Building and Planning Department
2400 Byberry Road
x
Bensalem, PA 19020
215-633-3644 ▪ Fax 215-633-3753
The undersigned applicant hereby makes application for a license to operate a Home Occupation business.
Applicant also understands he/she is also required to obtain the proper licensure from the Municipal Tax
Office pursuant to the Bensalem Township Business Privilege/Mercantile License Tax. Applicant affirms
that he/she has read the Code of the Township of Bensalem Section 232-594, “Home Occupations” and
understands that he/she is bound b
all o
the provisions set
orth in the Ordinance.
