Test Forms

Michigan

Contact Information

Date(Required)
Name(Required)
Address(Required)
Example: house, modular, mobile home, doublewide, garage, pole bldg, RV, etc.

Property Information

Needed information regarding the property you are wanting the new address for:
Is property to be split?
Please use this # format: 62-##-##-###-###
Please provide in feet (ft.)
East
New Construction
Existing Building
Cell Tower
Power Pole
Out Building
Signature of Property Owner (By typing your name this will considered your Official Signature)

New House Number Assignment

THIS IS ONLY TO BE FILLED OUT BY OUR STAFF. DO NOT FILL OUT.
Number Issued:
Number
Direction
Street Name
 
State:
Address
Approved By:
Date