Michigan City Short-Term Rental Permit Application

2. Property Address*
4. Property Owner First Name*
5. Last Name*
7. Street Address*
9. Mailing Address
   (if different from street address)
11. Primary Phone*
12. Email Address*
16. Is the Owner a Corporation or Partnership?

    1. Yes
    2. No
18. Names
19. Owner's State of Incorporation or Organization
    -- Select One --ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVAWAWVWIWY
21. Residence Addresses
23. Telephone Numbers of Owner's Principal Officers or Partners
27. Is property manager used?

    1. Yes
    2. No
29. Property Manager's First Name
30. Last Name
32. Street Address
34. Mailing Address

    (if different from street address)

36. Primary Phone
37. Email Address
41. Property Description
43. The advertised occupancy limits of each short term rental.
44. The short term rental is:

    1. A single family home.
    2. A dwelling unit in a single family home.
    3. A dwelling unit in a two-family or multifamilly dwelling.
    4. A dwelling unit in a condominium, cooperative, or time share.
46. The short term rental platforms wherein the short term rental is advertised for occupancy - Insert the property rental listing link for each platform (if applicable).
48. AIRBRB
50. VRBO
52. Other

    Please separate each link with a ;

54. Upload a document to the house rules for property as listed on each platform (optional)
58. If any information provided by an owner to a unit in the permit application changes, the owner shall provide updated information to the Planning & Inspection Department within thirty (30) business days after the change.
60. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
62. Electronic Signature
63. Date
    Date
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit

* indicates a required field