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Accessory structure demolition application
Owner Name
Owner Name
*
Date
Date
*
Property Address
Property Address
*
City
City
*
State
State
*
Zip
Zip
*
Email
Email
*
Home Phone
Home Phone
*
Cell Phone
Cell Phone
List all resident household members (people living in the household full time)
List all resident household members (people living in the household full time)
Include self
Resident 1
Resident 1
Name
Name
*
D.O.B
D.O.B
*
Age
Age
*
Relationship to Owner/Applicant
Relationship to Owner/Applicant
Race and/or Ethnicity (select all that apply)
Race and/or Ethnicity (select all that apply)
Hispanic/Latino
Black/African American
Asian
American Indian/Alaska Native
Native Hawaiian/Pacific Islander
White
Middle Eastern/North African
Other
Prefer not to answer
This section is voluntary and for reporting only. It will not affect eligibility.
Disability Status
Disability Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. Disability is defined as a long term condition that substantially limits the ability to live independently
Military/Veteran Status
Military/Veteran Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. It will not affect eligibility.
Resident 2
Resident 2
If applicable
Name
Name
D.O.B
D.O.B
Age
Age
Relationship to Owner/Applicant
Relationship to Owner/Applicant
Race and/or Ethnicity (select all that apply)
Race and/or Ethnicity (select all that apply)
Hispanic/Latino
Black/African American
Asian
American Indian/Alaska Native
Native Hawaiian/Pacific Islander
White
Middle Eastern/North African
Other
Prefer not to Answer
This section is voluntary and for reporting only. It will not affect eligibility.
Disability Status
Disability Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. Disability is defined as a long term condition that substantially limits the ability to live independently
Military/Veteran Status
Military/Veteran Status
Yes
No
Prefer not to Answer
This section is voluntary and for reporting only. It will not affect eligibility.
Resident 3
Resident 3
If applicable
Name
Name
D.O.B
D.O.B
Age
Age
Relationship to Owner/Applicant
Relationship to Owner/Applicant
Race and/or Ethnicity (select all that apply)
Race and/or Ethnicity (select all that apply)
Hispanic/Latino
Black/African American
Asian
American Indian/Alaska Native
Native Hawaiian/Pacific Islander
White
Middle Eastern/North African
Other
Prefer not to Answer
This section is voluntary and for reporting only. It will not affect eligibility.
Disability Status
Disability Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. Disability is defined as a long term condition that substantially limits the ability to live independently
Military/Veteran Status
Military/Veteran Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. It will not affect eligibility.
Resident 4
Resident 4
If applicable
Name
Name
D.O.B
D.O.B
Age
Age
Relationship to Owner/Applicant
Relationship to Owner/Applicant
Race and/or Ethnicity (select all that apply)
Race and/or Ethnicity (select all that apply)
Hispanic/Latino
Black/African American
Asian
American Indian/Alaska Native
Native Hawaiian/Pacific Islander
White
Middle Eastern/North African
Other
Prefer not to Answer
This section is voluntary and for reporting only. It will not affect eligibility.
Disability Status
Disability Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. Disability is defined as a long term condition that substantially limits the ability to live independently
Military/Veteran Status
Military/Veteran Status
Yes
No
Prefer not to answer
This section is voluntary and for reporting only. It will not affect eligibility.
STATEMENT OF INCOME
STATEMENT OF INCOME
LIST THE ANNUAL (YEARLY) GROSS INCOME BEFORE TAXES OF ALL HOUSEHOLD MEMBERS INCLUDING YOURSELF:
Resident 1
Resident 1
Household Member Name </br>
Household Member Name
*
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
*
Annual Income
Annual Income
*
Resident 2
Resident 2
If applicable
Household Member Name
Household Member Name
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Annual Income
Annual Income
Resident 3
Resident 3
If applicable
Household Member Name
Household Member Name
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Annual Income
Annual Income
Resident 4
Resident 4
If applicable
Household Member Name
Household Member Name
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Source (Job, SSI, Disability, rental income, Welfare, Unemployment, etc.)
Annual Income
Annual Income
Total Annual Household Income
Total Annual Household Income
*
PREVIOUS ASSISTANCE
PREVIOUS ASSISTANCE
Have you ever received housing assistance from the Redevelopment Authority of the City of Erie?
Have you ever received housing assistance from the Redevelopment Authority of the City of Erie?
*
Yes
No
If Yes, What Year?
If Yes, What Year?
GENERAL HOUSING QUESTIONS
GENERAL HOUSING QUESTIONS
These help determine qualifying funding sources. Please do not leave blank.
Are you the owner of this property?
Are you the owner of this property?
*
Yes
No
If there is a mortgage, is it current or able to be made current?
If there is a mortgage, is it current or able to be made current?
*
Yes
No
Are property taxes, and water, sewer, and refuse bills current or able to be made current?
Are property taxes, and water, sewer, and refuse bills current or able to be made current?
*
Yes
No
Are you on a payment plan for any of the above? If "yes," please explain
Are you on a payment plan for any of the above? If "yes," please explain
Do you live at this property?
Do you live at this property?
*
Yes
No
Has this property received a code violation or any other notice from the City of Erie? Please specify.
Has this property received a code violation or any other notice from the City of Erie? Please specify.
*
Yes
No
If Yes Please Explain
If Yes Please Explain
Accessory Structure Details
Accessory Structure Details
Is the structure physically attached to any other structure?
Is the structure physically attached to any other structure?
*
Yes
No
Type of Structure
Type of Structure
*
Approximate Size
Approximate Size
Is the structure located entirely on your property?
Is the structure located entirely on your property?
*
Required Documents
Required Documents
May be uploaded here, brought in person to 626 State Street, or emailed to intake@redeveloperie.org
Photo ID
Photo ID
Deed or Proof of Ownership
Deed or Proof of Ownership
Income Documentation
Income Documentation
Most recent 2 months of paystubs and/or current award letters (SSI/SSD, Unemployment, Pension, etc.)
Homeowner's Insurance Declarations Page
Homeowner's Insurance Declarations Page
Code Notice / Citation (if applicable)
Code Notice / Citation (if applicable)
Structure Photo 1
Structure Photo 1
Structure Photo 2
Structure Photo 2
}
About
Who We Are
Staff
Board of Directors
FAQs
Bidding on Projects
RACE History
Programs & Initiatives
Housing Rehab
ARP Healthy Homes
Lead Hazard Control
Historic Building Improvement
Blight Mitigation
Erie County Whole Home Repair
Accessory Structure Demolition
Apply
Available Properties
Vacant Lots
Properties
Events
Resources
