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Greene County Address Application

2. Name

   Name of person requesting address

3. Phone

   Phone number of person requesting address

5. Map / Parcel Number

6. Name of Street, Highway, or Road

8. Property Owner's Name

9. Property Owner's Phone

11. Email Address

15. Is there a structure on the property?

    1. Yes
    2. No

16. Please describe.

18. Is there an existing driveway?

    1. Yes
    2. No

19. Will it be used for access?

21. Plat, Site Plan, or Map

    Please identify the access location in the form of a plat, site plan, or map.

23. How many feet of road frontage?

25. Landmarks

    (i.e. water towers, bridges, creeks, mile markers, etc. close to property)

27. Power Company

28. Phone Company

32. Is the address for a business?

    1. Yes
    2. No

33. Do you have a permit?

    1. Yes
    2. No

35. Permit

    Please attach an approved copy of the permit from the Planning and Zoning Office.

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field