Permit Application For Temporary Sidewalk/Street Sales
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Date: __________
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Property Owner's Name
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Company's Name
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Address
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Phone - Day Night
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Seller's Name
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Location of Selling Area
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Phone - Day Night
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Type of Sales
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Brookhaven Mercantile Tax Number
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PA State Sales Tax Number
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Liability Insurance Carrier
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Insurance Home Office Phone Number
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Insurance Agent's Phone Number
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This Application shall be filled out by applicant in person
at the Brookhaven Borough Secretary's Office during normal business
hours. Proof of required documents shall be verified on day of Application.
Application will be approved or disapproved 10 business days prior
to start date of sale, providing all requirements are met. The Permit
Application form cannot be submitted to the Borough at any time sooner
than 30 days prior to the day of sale or the initial day of sale if
the sale will last more than one day.
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I certify the above information is true and correct:
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Applicant's Signature
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Property Owner's Signature
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Application Received by Borough Secretary on
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Borough Secretary's Signature
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Approved:
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Permit
Sidewalk/Street Sales
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Permit # 93-_____ Issue Date _____
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This is to certify that _____ has met the application requirements
to obtain this permit to sell _____ within the limits of (location of selling area) for a period of _____ days
from _____ to _____, 20 _____ for the fee of (per ordinance) dollars paid to the Borough. This permit is issued subject to Borough
ordinance relating thereto, and to the police rules and regulations.
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This permit expires midnight _____ and is non-transferable.
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Witness my hand and seal of Brookhaven Borough this _____ day
of _____, 20__.
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Seal
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Borough Secretary
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