ADDRESS REQUEST/VERIFICATION FORM

** NOTE**

When you submit the address request form, you will receive a confirmation email from addressing@baldwin911.org.

Please Select One *

Property Owner *

Are you the property owner?

Property Owner's Name *

Address to Verify *

ie. 23171 McAuliffe Dr

Community *

Please provide the city or community name for the location of your address request.

Owner's Contact Number *

Owner's Email *

Owner's Email Verification *

Please verify the property owners email address by re-typing it here.

Neighbor

The address number of your nearest neighbor on the same road.

Name of person requesting address *

Contact Number *

Email of Person Requesting *

Email of Person Requesting Verification *

Please verify your email address by re-typing it here.

Relationship to owner *

Agency Name

Name of the agency requesting the address or address verification.

Parcel Number *

ie. 05-33-02-04-3-000-090.001

05-

PPIN *

Parcel # lookup: https://bit.ly/39iPMT3 (Click link to Revenue Commision map if you don't know your #'s.)

Structure type *

Commercial - Business Name

Utility Type

ie. temp pole, garden pump

Other

Upload Site Plan *

Please include a copy of the site plan showing where the structure will be located on the property. Include measurements of the center of the driveway to the nearest property line.
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

We prefer that you upload a site plan, however if you don't have one please provide your coordinates for the new location:
1) Click this link to go to Google Maps. (This will open up a new tab.)
2) Pan/Zoom to your property location.
3) Select the approximate location on your property for where you would like a new address assigned.
4) Right click your mouse and select the "What's Here" option.
5) Your approximate coordinates will appear in the box.

Latitude

Coordinates for structure requiring an address (if known) Latitude - ie. 30.562217

+ N

Longitude

Coordinates for structure requiring an address (if known) Longitude - ie. -87.730353

- W

Comments

Optional - Enter any comments or special instructions that will help process your request.

CAPTCHA

This question is to prevent automated spam submissions.

Math question * 7 + 7 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

Addressing Department	251.947.5911
Business Office	251.947.3911
Office Fax	251.947.2740
Dispatch Fax	251.947.9600

Emergency Dial 9-1-1

Radio Tower Space Available

ADDRESS REQUEST/VERIFICATION FORM