Form Center

2. 
4. BASIC INFORMATION
6. Project Name*
7. Date Submitted*
   Date Submitted

   Date Submitted
9. Project Address*
11. City*
12. State*
13. Zip Code*
15. Signature*
    (Type your name)
16. Form Submitted
    Form Submitted

    Form Submitted
18. CONTACT INFORMATION
20. Owner/Organization*
21. Telephone Number*
23. Contact Person*
24. Email Address:
26. ARCHITECTURAL INFORMATION
28. Architectural Firm
29. Telephone Number
31. Contact Person
32. Email Address
34. PROJECT MANAGER
36. Project Manager
37. Telephone Number
39. Contact Person
40. Email Address
42. The following documents will be needed when submitting this application.*

    1. Proof of Ownership
    2. Parcel number(s):
44. Please provide complete list of Parcels.
46. BUILDING/SITE DESCRIPTION
48. Class 1 Structure? (Select one)*

    1. Industrial
    2. Commercial
49. Is the project in a Flood zone? (Select one)*

    1. Yes
    2. No
51. RESIDENTIAL
53. Residential (Structure)
    -- Select One -- Existing Structure - YES New Structure - YES Other
54. If "yes," specify the following:
56. Describe type of Residential Structure.
58. No. of dwelling units?
59. Gross floor area (sq. ft.)
61. COMMERCIAL
63. Commercial (Structure)
    -- Select One -- Existing Structure - YES New Structure - YES Other
64. If "yes," specify the following:
66. Describe type (retail, office, etc.)
68. Gross floor area (sq. ft.)
70. INDUSTRIAL
72. Industrial (Structure)
    -- Select One -- Existing Structure - Yes New Structure - Yes Other
73. If "yes," specify the following:
75. Type of use
77. Gross Floor area (sq. ft.)
78. Open Storage area (sq. ft.)
80. If any unenclosed activities, specify:
82. OTHER - Land Use
84. If "yes," describe:
86. PROJECT VALUATION/FUNDING
88. Estimated Dollar Valuation of Project:*
90. * Please note that all personal information submitted to the City of East Chicago is confidential, to the extent permitted by law.
92. DEPARTMENTAL USE
97. Township:
    North
98. County
    Lake
100. TECHNICAL REVIEW DATE:
103. PLANNING COMMISSION DATE:
106. BOARD OF ZONING AND APPEALS (BZA) Hearing Date:
Leave This Blank:


110. 1. Receive an email copy of this form.
111. Email address

     This field is not part of the form submission.

112. Submit

* indicates a required field