West Hempfield Township

Fill out an Appendix 24 Application :

Rick's Fun Pizza

Project ID : 72

Preliminary Review: 1st phase

Appendix 24 Status	Active

Application Received	10/10/2003 2:25:30 PM

DSF User Name	test user

LCPC Number	89-134A

Jump to a specific section of the application...

Applicant • Owner • Parcel • Building/Plan • Access/Parking • Utilities • Fees

* Required information before submitting to LCPC

Applicant Information

Applicant

First name*	Last name*

Company

In Care Of...

Address

Address line 1*

Address line 2

City*	State*	Zip Code*

Phone*

Owner Information


	Add Owner

	Owner and applicant are same person

Owner

First name*	Last name*

Company

In Care Of...

	Property is in Urban Growth Boundaries

Address

Address line 1*

Address line 2

City*	State*	Zip Code*

Phone*

Section Information

Section No. of Ordinance

Section Description

Parcel Information

Location of Parcel

Description of Proposed Usage*

Description of current usage

Parcel Account Number(s) *

Tax Map Number

Additional municipalities from adjacent counties

Which Municipality(s) is the Parcel in?*

Number of Lots on the Parcel*

Acreage Proposed for Park
or Other Public Use

Lot

District

Map

Block

Current Zoning

Building & Plan Information

Plan Name*

Plan Number*

Proposed Employees

Expected Employees

Building Type

Plan Date (ex.: 12/12/2002) *

Building Square Footage

Plan Acreage

Number of Units*

Access & Parking


	Notify PADOT of My Application for Permit

Streets Not Proposed for Dedication

Lineal Feet of New Street

Existing Parking Spaces

Proposed Parking Spaces

Utilities

Electric Supplier

Gas Supplier

Telephone Supplier

Sewer Supplier

Water Supplier

Cable Supplier

Fees

Base Fee*

Lots Fee*

Sq Footage Fee*

Waiver Fee*

Reduction Fee*

Storm Water Fee*

Total Fee

$60.00