Apply For Utility Address

The Applicant is responsible for complying with all applicable laws and regulations.
The utility cannot be accurately addressed unless the utility location is indicated on the plan/plat or image provided. If the utility location is later found to be inaccurate, the utility may require an address change.
Your request MUST include a copy of the site plan/plat or image.
The plat/plan must include:
1. Utility location (marked and labeled “Utility”).
2. Nearest address.
The utility will be addressed using the utility location, closest address and corresponding street.

Utility Address Request Form

Phone

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Utility Company Phone Number(Required)

Alternate Phone Number

Email(Required)

Utility Company Name(Required)

Daytime Phone Number(Required)

Tax Map (If Applicable)

Group (If Applicable)

Parcel (If Applicable)

Address nearest the Utility/Meter(Required)

Road/Street Name(Required)

Have you supplied an image showing utility location?(Required)

Yes

Upload Image Showing Utility Location(Required)

Max. file size: 120 MB.

Description

Applicant's Signature(Required)