CITY OF PEORIA 
COMMUNITY DEVELOPMENT DEPARTMENT

Complete this Form and Fax to 623-773-7245
We will respond to your request by the next business day

(Please use a separate form for each request)



Check One: 	( ) REQUEST FOR PERMIT/PARCEL INFORMATION
    		( ) GROUP HOME INFORMATION

BUSINESS NAME:

REQUESTOR’S NAME:

REQUESTOR’S PHONE:
OFFICE:
FAX:
ADDRESS TO BE RESEARCHED:

PARCEL NUMBER TO BE RESEARCHED:

DESCRIPTION OF PROJECT TO BE RESEARCHED:  (e.g., House, Commercial, Restaurant, Store) INFORMATION REQUESTED
(Please Check the Applicable Boxes)

PARCEL NUMBER

ADDRESS

CONTRACTOR’S NAME/ADDRESS

OWNER’S NAME/ADDRESS

ZONING INFORMATION

GROUP HOME LOCATION

OTHER: (Please Specify)


For City of Peoria use only
Information provided by (employee name and extension): ____________________________________
Date/time: ________________________