2. St. Joseph County, Indiana
   GIS Data Request Form
3. 
5. Data shall not be released to third parties without the express written permission of St. Joseph County. If there is a charge for this request, you will be contacted prior to processing this request.
6. Date*
   Date
8. Requested by:
10. Name*
11. Organization
13. Address*
14. Department
16. City, State, Zip*
17. Title
19. Contact Number*
20. Email*
22. Area of Interest:
    (Include parcel number(s), or section number, range and township, or name the roads that encompass the area, or attach a copy of the legal description, or provide a map depicting the area of interest)
23. Attachment (Image)
    Upload the image of the area of interest
25. Delivery Method:*

    1. Email
    2. Digital Download (FTP, DropBox, etc.)
    3. Pick-up in GIS Office
26. Delivery for Digital: FTP, DropBox, etc. (include login & password of site address)
28. Government Contact*

    1. YES

    1. NO

    * If "YES", please fill out the portion below.
30. Government Contact Name & Department
32. Government Contact Number
34. Layers List:
    * If the requested layer is for the entire County a Provisional Data Usage Agreement will need to be completed and a $200 fee will need to be collected prior to sending the layer (Cash or Check only).
35. SJC GIS Data Agreement:
    Provisional Data Usage Agreement
37. Check all that apply:

    1. Address Centerline
    2. Address Grid
    3. Address Points
    4. Annexations
    5. Census: Tract
    6. Census: Block Group
    7. Centerline: Toll Rd, US Roads, State Roads
    8. City Council Districts
    9. Civil Townships
    10. County Council Districts
    11. Flood Hazard Areas
    12. Hydrology: Rivers, Lakes, Streams
    13. Incorporated City/Town Bounary
    14. Land Use
    15. Parcel
38. Check all that apply:

    1. Parks
    2. Railroad Centerline
    3. Road Right of Way
    4. School Districts
    5. School Locations
    6. Soils
    7. Subdivisions
    8. Survey Sections
    9. Tax Districts
    10. Topography
    11. Vacations
    12. Voter Precincts
    13. Wetlands
    14. Zoning
40. Aerial Photography for the following years, please check all that apply:

    A $25.00 fee will be assessed for each tile (quarter square mile).

    1. 1966
    2. 1972
    3. 1987
    4. 1993
    5. 1998

    1. 2003
    2. 2006
    3. 2007
    4. 2008
    5. 2010

    1. 2011
    2. 2013
    3. 2015
    4. 2016

    1. 2017
    2. 2018-only a 1 mile River Buffer
    3. 2019
    4. 2021
42. Building Structures Layer, please check all that apply:

    1. 2017

    1. 2019

    1. 2021
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit Submit and Print

* indicates a required field