Rev 3/2009
Permit #
Date
NAME:
ADDRESS:
PHONE No: FAX No:
Email:
PLEASE RESEARCH THE FOLLOWING ADDRESS LOCATED AT:
Note: One property per request.
Location:
TAX PARCEL No.: 02 -
ADDITIONAL INFORMATION:
SPECIFIC INFORMATION BEING REQUESTED:
I DO NOT WANT COPIES
I WANT COPIES OF THE INFORMATION FOUND AND ACKNOWLEDGE THE COST OF $.25 PER PAGE
LARGE PRINTS WILL BE SENT OUT TO BE COPIED AND CHARGED AT ACTUAL COST.
NOTE:
Information requested requires a five (5) day waiting period to allow time for research.
If research requires additional time, applicant will be contacted to sign an approval for a 30 day extension of time.
OFFICE USE ONLY
FEES:
Total number of pages: $.25/ per page $
Total number of plans: / per page $
TOTAL ALL FEES:
$
Township of Bensalem Department of Building and Planning
BENSALEM TOWNSHIP
Building And Planning Department
Office 215-633-3644 ▪ Fax 215-633-3753
2400 Byberry Road ▪ Bensalem, PA 19020
REQUEST FOR INFORMATION
PPLICATION
