City of Philadelphia | Project Information Form

Please fill out this form the best to your ability. Please write in "N/A" if the question does not apply to your project. This form is completed by the Applicant to provide a standard set of public information about each project. Statements made by the Applicant in the form are solely those of the Applicant. The City of Philadelphia, including the Philadelphia City Planning Commission, the Civic Design Review Committee, and the Department of Licenses and Inspections, does not review or control the statements made by the Applicant. No statement in the form creates any contractual or other legal obligation; nor may any statement in the form be used to satisfy any legal obligation. The statements in the form cannot be presented as evidence to, and may not be considered by, the Zoning Board of Adjustment or the Civic Design Review Committee.

* Indicates required field

Applicant Information

Address of Development Project*

Addresses that include an address range (example: 123-36 N. Broad Street) cannot be verified. If possible, please only include one address per location).

Council District #

The council district number is filled in automatically based on your address.

Name of Applicant*

First Last

Zoning Application Number*

Address of Applicant*

Street Address Address Line 2 City State ZIP / Postal Code

Contact Information

Please provide below the name, phone number, and/or email of a contact person that the local community can reach out to with any questions or concerns.

Is the contact person the same as applicant?

Yes

Name of Contact Person*

First Last

Phone Number of Contact Person

Email Address of Contact Person*

Project Information

Is your project exclusively residential?*

Yes
No

Does your project contain three or fewer units?*

Yes
No

Does your project result in a total of 2,500 square feet or more of floor area?*

Yes
No

Is your zoning application exclusively for signage?*

Yes
No

Key Project Statistics

Current Land Use on Parcel(s):*

Proposed Land Use on Parcel(s):*

Net Change in Number of Housing Units:*

Net Change in Commercial Square Footage:*

Net Change in Total Floor Area:*

Net Change in On-Street Parking:*

Number of Off-Street Parking Spaces to be Provided:*

Approximate Projected Construction Period:*

Please provide a brief summary of your proposed project:*

Please describe any planned changes to the landscaping and lighting on any public space within or adjacent to your project:*

Please describe any anticipated impacts on the transportation network (e.g. parking, sidewalks, street safety or traffic, transit) and any plans for mitigating any negative impacts:*

Approximately how many full time equivalent jobs (if any) are currently located on site?*

Approximately how many full time equivalent workers will be employed on-site during the construction period?*

Approximately how many full time equivalent jobs (if any) will be located on-site after construction is complete? Approximately how many of these jobs (if any) will be paid a wage of at least $15/hour and will include health and/or retirement benefits?*

Describe your plan, if any, to increase the supply of affordable housing:*

Please describe any partnerships with local community organizations that will be utilized during and/or after construction:*

Please provide a brief summary of any plans for local hiring and job training/apprenticeships during or after construction. Also, please indicate whether you plan to submit an Economic Opportunity Plan to the Office of Economic Opportunity:*

Please describe any other anticipated community impacts (positive or negative) associated with this project:*

Sign & Submit

Agreement:*

I understand that all information submitted on this form is public information.

Printed Name of Applicant*

Please sign with the Initials of the Applicant*

Date*

MM

DD

YYYY

Name

This field is for validation purposes and should be left unchanged.

City of Philadelphia Project Information Form

Project Information Form

Applicant Information

Contact Information

Project Information

Key Project Statistics

Sign & Submit