Residential Rental License

MOUNT GRETNA BOROUGH

101 CHAUTAUQUA DRIVE
P.O. BOX 61
MOUNT GRETNA, PENNSYLVANIA 17064
(717) 964-3270
REGISTRATION FOR RESIDENTIAL RENTAL LICENSE Date Registration

(A separate application is required for each rental unit) Received by Borough:
_______________________
Property Address: _____________________________________________________
(Street Address – No Post Office Box Number)
Phone number to residential unit:___________________________________________
Property Owner Information (Must include all owner’s names and addresses)

Name:____________________________________________________________

Address: __________________________________________________________

(Street Address – Including any Post Office Box Number)

Phone (day)____________ (Evening)____________ Cell___________ Fax__________

Email__________________________ 24 hour emergency phone number ____________

Property Manager Information (If Applicable)

Name:____________________________________________________________

Address:___________________________________________________________

Phone (day)_______________ (Evening)______________ Cell___________________

Fax______________ Email____________________________________________

24 hour emergency phone number__________________________

Maximum Number of tenants/occupants in this rental unit
(Occupants):________________ Fee is $40 per dwelling unit.

Payment must accompany registration form.

Make check payable to Mount Gretna Borough.

Forms must be returned by December 31st.