Modified 3/20/2017
PROPERTY TRANSFER OR REFINANCE APPLICATION
In accordance with Chapter 202 (property transfers) and
Chapter 217 (Sewer and Sewer Disposal)
Lot & Block Number ________________ Application Number __________________________
Property Address _______________________________ City ________________ State & Zip Code _________
Building Type: Commercial with ______units in building;
Mixed Use: with ______Commercial units and _________ Residential units
Residential: Single Family; Apartment with _______ units in building
Financial Transaction Refinance Property Transfer Foreclosure
Existing Owner __________________________ Phone Number ______________ E-Mail __________________
Owner Address ____________________________ City ________________ State & Zip Code ______________
Prospective Buyer Name ____________________ Telephone # ____________ E-Mail ____________________
Prospective Buyer Address ______________________ City ________________ State & Zip Code ___________
Realtor or Agent Name ____________________ Realtor Telephone # ________________ E-Mail ___________
Additional Addresses Associated with Parcel ____________________________________________________
_________________________________________________________________________________________
Fees
Lien letter $50.00
Sewer Compliance $25.00
*EXPEDITED FEES MAY APPLY
ALL INFORMATION ON THIS APPLICATION IS REQUIRED IN ORDER TO PROCESS YOUR REQUEST.
UNLESS THE PROPERTY HAS BEEN DYE TESTED IN THE LAST TWO YEARS OR LABELED EXEMPT BY THE
BOROUGH, YOU MAY HAVE TO SUBMIT AN “APPLICATION FOR DYE TEST CERTIFICATE OF COMPLIANCE
COMPLETED BY A REGISTERED MASTER PLUMBER.
PRIOR TO NEW OWNERS OR ANY OTHER TENANTS OCCUPYING THE PROPERTY, AN APPROPRIATE
APPLICATION FOR OCCUPANCY INSPECTION WILL BE REQUIRED FOR EACH DWELLING UNIT. NO TENANT
CAN OCCUPY A PREMISIS UNTIL AN OCCUPANCY PERMIT IS ISSUED.
APPLICATIONS RECEIVED WITH INCOMPLETE INFORMATION OR FEES WILL NOT BE PROCESSED.
Borough of Wilkinsburg
Code Enforcement
Municipal Building
605 Ross Avenue
Wilkinsburg, PA 15221
Phone: (412) 244-2923 Fax: (412) 244-2922
www.wilkinsburgpa.gov
Modified 3/20/2017
UNDER SECTION 107.6 OF IPMC IT SHALL BE UNLAWFUL FOR THE OWNER OF ANY DWELLING UNIT OR
STRUCTURE WHO HAS RECEIVED A COMPLIANCE ORDER OR UPON WHOM A NOTICE OF VIOLATION HAS
BEEN SERVED TO SELL, TRANSFER, MORTGAGE, LEASE OR OTHERWISE DISPOSE OF SUCH DWELLING UNIT
OR STRUCTURE TO ANOTHER UNTIL PROVISIONS OF THE COMPLIANCE ORDER OR NOTICE OF VIOLATION
HAVE BEEN COMPLIED WITH, OR UNTIL SUCH OWNER SHALL FIRST FURNISH THE GRANTEE, TRANSFEREE,
MORTGAGEE OR LESSEE A TRUE COPY OF ANY COMPLIANCE ORDER OR NOTICE OF VILOATION ISSUED
BY THE CODE OFFICIAL AND SHALL FURNISH TO THE CODE OFFICIAL A SIGNED AND NOTARIZED
STATEMENT FROM THE GRANTEE, TRANSFEREE, MORTGAGEE OR LESSEE, ACKNOWLEDGING THE RECEIPT
OF SUCH COMPLIANCE ORDER OR NOTICE OF VIOLATION AND ACCEPTING THE FULL RESPONSIBILITY
WITHOUT CONDITION FOR MAKING THE CORRECTIONS OR REPAIRS REQUIRED BY SUCH COMPLIANCE
ORDER OR NOTICE OF VIOLATION.
Please print clearly. Illegible and incomplete forms will not be accepted. Please remit payment
with this application. For Corporations, a form of identification of an authorized officer of the
company, or copy of a written agreement of the corporation’s registered agent is required.
The undersigned hereby represents that, to the best of his/her knowledge, belief that all
information listed above is true, correct, and complete; and that all attachments contain the
required information.
Applicant Signature
Print Name: ___________________________________________
Signature: ____________________________________________ Date: ______________
For Office Use Only
Permit Number __________
Fee Paid $ ______________
Approved By: __________________________________________ Date: __________
Title: _________________________________________________