Fillable Use Occupancy - Rental 2017 - Use & Occupancy Rental Application

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Use Occupancy - Rental 2017 - Use & Occupancy Rental Application

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File type: PDF

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BENSALEM TOWNSHIP
Building and Planning Department
2400 Byberry Road • Bensalem, PA 19020
Office 215-633-3644 • Fax 215-633-3753
Permit #:
Fee:
Date:
APPLICATION
RENTAL USE & OCCUPANCY
COMPLEX NAME:
ADDRESS:
UNIT No.:
TAX PARCEL No.:
OCUPANCY PERMIT No.:
MOVE IN DATE:
TERM OF LEASE:
Leaseholder(s) Name(s):
1.
2.
List the names of all persons who will be occupying the stated unit:
1.
2.
3.
4.
Owner’s Name
Phone No.:
Email Address:
Fax No.:
Date Submitted:
OFFICE USE ONLY
CASH CHECK MONEY ORDER
Rev. 10
/
2010
& Signature
A SIGNED COPY OF THIS APPLICATION IS REQUIRED PRIOR TO ISSUANCE OF PERMIT
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Use Occupancy - Rental 2017 - Use & Occupancy Rental Application

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Completed 11 July 2020

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