Fillable Waiver Curbs-sidewalks 2017 - Waiver Curbs-Sidewalks

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Waiver Curbs-sidewalks 2017 - Waiver Curbs-Sidewalks

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BENSALEM TOWNSHIP
Building and Planning Department
Office 215-633-3644 ▪ Fax 215-633-3753
2400 B
y
berr
y
Road ▪ Bensalem
,
PA 19020
Permit #
Date
Fee:
Property Owner Information
NAME:
ADDRESS:
PHONE No.:
Applicant Information
NAME:
ADDRESS:
PHONE No.:
Status of Applicant
Property Owner Developer
Equitable Owner Purchaser
Other
Site Information
Location:
Tax Parcel No.
Signature
Owner Applicant
Date Signed
Township Engineer’s Recommendation:
Decision of the Bensalem Township Council:
Approved Denied
Date Signed:
Comments:
Rev 5/2016
REQUEST FOR WAIVER
of CURBS & SIDEWALKS INSTALLATION
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Waiver Curbs-sidewalks 2017 - Waiver Curbs-Sidewalks

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Completed 11 July 2020

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