Property Referral Form

Property Referral Form

Please fill out this form if you are part of a Lancaster Municipal government body interested in referring a property to be considered for entry into our Vacant Property Reinvestment Program

Basic Property Information
Address of Property

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload several color photographs of the property; including front, rear and both sides, if appropriate. Photographs showing neighboring properties would also be useful.

Cancelof
Name of Current Property Owner

First NameLast Name
Address of Current Property Owner

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the property currently vacant?

YesNo
If yes, for how long?
Has the property been condemned by the municipality?

YesNo
If yes, on what date?
IF THE PROPERTY THAT IS BEING REFERRED TO THE VACANT PROPERTY REINVESTMENT BOARD PROGRAM BECOMES OCCUPIED, THEN THE PROPERTY WILL NO LONGER BE CONSIDERED VACANT. THUS, THE PROPERTY WILL BE REMOVED FROM THE PROGRAM, EFFECTIVE THE DATE THAT THE INITIAL OCCUPANCY TAKES PLACE.

Additional Property Information
How long have the conditions of blight described above existed? (number of years/months/years)
What was the most recent previous use of the property?
If other, please describe:
Please provide a brief history of citations issued that document code violations, including dates of notification of violations and whether violations still exist.
Please see next question if you would prefer to attach citations or written reports rather than list violations.
If you would prefer to attach citations or written reports rather than list violations, pleas attach files here.

Cancelof
Provide any information regarding prior or current rehabilitation of this property.
List utilities that have been disconnected and date on which they were cut off (if known).
Has your municipality committed funds for acquisition, rehabilitation, or demolition for this property?

YesNoUnknown
If you answered yes to the previous question, please state an amount, if known. (Preference may be given for properties for which a municipality has stated a willingness to contribute funds for acquisition, rehabilitation, or demolition).
Is there any other information that you would like to provide?
We will acknowledge all property referral forms received; however, because of resource restraints, the Vacant Property Reinvestment Board may not be able to pursue every property referral.

Please contact Sean Krumpe at the Lancaster County Redevelopment Authority at (717) 394-0793 ext. 232 (or skrumpe@lchra.com) if you have any questions on how to complete this form.

Applicant Information
Name of applicant completing this form:

First NameLast Name
Title:
Municipality:
Municipal Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date

MonthDayYear
Date
Should be Empty: