New Philadelphia Housing Plan - Empty/Vacant Lot Form

James Shively

January 17, 2024

Name

Person Submitting Property For Program Consideration

First Name

Last Name

Organization & Title

(optional)

Parcel I.D.

(optional) Please Enter the Parcel Number Found on the County Auditor's Website

Address

Provide Address of Empty/Vacant Lot

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Public/Private Owner

Indicate Whether The Property Is Owned Publicly or Privately

Public Ownership

Private Ownership

Not Sure

Owner's Name

(optional) if available

Owner's Phone

(optional) if available

(###)

###

####

Owner's Email

(optional) if available