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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