Form PZ ST No Ap 3/1/00
Town of Greenwich
Planning & Zoning Department
Town Hall – 101 Field Point Road - Greenwich, CT 06836-2540
Phone: (203) 622-7894 - Fax: (203) 622-3795
Application for Street Number
The following information is required for house number assignment. (A house number assignment is
required prior to obtaining a building permit.) Allow one week or more for processing and verification.
Name of Property Owner: Last _______________________ First _______________________
Street Name: ____________________________ Side (North, South, East, West): ____________
If property fronts on two or more streets, on which street is driveway access?
______________________________________________________________________
Assessor’s Map #: _____________ Lot #: ______________ Lot Size: ____________
Tax Account #: __________________ Number of Units: ____________________
Check One: New Building Existing Building
Name of Previous Property Owner: Last ____________________ First ____________________
Cross References: (Adjacent numbers, previous number, store names, subdivision name, etc.)
_____________________________________________________________________________
Requesting Agent
Name: Last ____________________ First ____________________ Phone: ____-____-_______
Address: ______________________________________ or FAX Number: ____-____-_______
Occupant’s Name (if different from Owner) Last _________________ First _________________
Please attach copy of plot plan or survey showing building and driveway location.
Signature of Property Owner:
__________________________________________________
Planning & Zoning Confirmation: OFFICE USE ONLY
Address Issued _____________________________________________________________
Post Office Confirmation _____________________________________________________
Notification Sent ____________________________________________________________
