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Rental Application

  1. Borough Logo
  2. Application for Residential Rental Permit
  3. Is this a new owner?*
  4. Type of Rental?*
  5. Any Units Owner Occupied?
  6. Who should be notified if any of the tenants are delinquent on utilities?
  7. Who should be notified about rental permit renewals and rental inspections
  8. Who should be notified about code violations
  9. I hereby verify that the information provided on this application is true and correct and to the best of my knowledge and information. I hereby affirm to abide by and adhere to the Code of the Borough of Ephrata and any and all applicable Federal or State laws, statutes or regulations.
  10. Pursuant to the Code of the Borough of Ephrata, the owner of a property shall be liable along with the tenant for the payment of utility services supplied to the leased premises and for all damages occurring because of the leasee’s misuse of utility service and/or equipment.
  11. The required payment of this permit acknowledges that as owner of this property you accept responsibility for the following: • Marking all water and electric meters to correspond with the appropriate apartment number or letter. • Notifying the Borough Business Office (717-738-9222) when there is a change in occupancy to verify the moving date. • Payment of utility bills while the property is vacant between tenants. • Payment of utility services supplied to the leased premises on the property if the tenant defaults. • Damages occurring because of the tenant’s misuse of the utility service and/or equipment.
  12. By entering your name and date above, you are signing this form and agreeing to all terms and conditions of this application.
  13. Leave This Blank:

  14. This field is not part of the form submission.