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4. Submission Options and Cost

   Form may be submitted online at the bottom of this fillable form or faxed. Fax # 708-563-9340. Inspections must be scheduled after submitting the form. Call 708-563-4809 Inspections are $100 payable to the Village of Summit at the Village of Summit Strzelczyk Municipal Center. 7321 W 59th Street Summit, Illinois 60501

6. Address of Property
8. Address*
10. City*
11. State*
12. Zip Code*
14. Property Permanent Index Number (PIN)
16. Current Owner Name*
17. Phone Number*
19. Current Owner Address (if not same as property)
21. City
22. State
23. Zip Code
25. New Owner Name*
26. Phone Number*
28. Address
30. City
31. State
32. Zip Code
34. If known:
36. Closing Date
    Closing Date
37. # of Units
38. Lot Size
39. House Size
41. Garage Size
42. Garage Construction Type
    -- Select One --FrameBrick
43. House Type Of Construction
    -- Select One --FrameBrickVeneerStoneOther
45. Electrical Service
    -- Select One --60 Amp100 AmpOther
46. Electrical Panel Type
    -- Select One --FuseBreakerOther
47. # Of House Stories
    -- Select One --1234
49. Main Floor
50. # Of Bedrooms
    -- Select One --123456Other
51. #Of Living Rooms
    -- Select One --10
52. # of Dining Rooms
    -- Select One --10
54. # Of Kitchen Rooms
    -- Select One --10
55. # Of Bath Rooms
    -- Select One --11.522.5
56. # Of Recreation Room
    -- Select One --10
58. 2nd Floor
59. # of Bedroom
    -- Select One --123456
60. # Of Living Room
    -- Select One --10
61. # Of Dining Room
    -- Select One --10
63. # Of Kitchens
    -- Select One --10
64. # Of Baths
    -- Select One --0.511.522.5
65. # Of Recreation Rooms
    -- Select One --10
67. Basement
68. # Of Bedrooms
    -- Select One --0123456
69. # Of Living Rooms
    -- Select One --01
70. # Of Dining Rooms
    -- Select One --01
72. # Of Kitchens
    -- Select One --01
73. # Of Baths
    -- Select One --00.511.522.5
74. # Of Recreation Rooms
    -- Select One --01
Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit Submit and Print

* indicates a required field