Form Updated: 03/2012
CITY OF DECATUR, TEXAS
1601 S. State Street
Phone 940-393-0250
Inspections Line 940-393-0259 * Fax 940-393-0251
APPLICANT INFORMATION:
Name: Company:
Address: Phone: Fax:
City: State: Zip: Email:
OWNER INFORMAITON:
Name: Company:
Address: Phone: Fax:
City: State: Zip: Email:
KEY CONTACT INFORMATION (The letter will be addressed to the Key Contact):
Name: Company:
Address: Phone: Fax:
City: State: Zip: Email:
PROPERTY INFORMATION:
The applicant is required to submit sufficient information that adequately describes the location of the property
on which the request is made.
Property Location:
Property Legal Description:
Does property currently have an address? Yes No; If Yes, Address:
# Lots: Acreage:
Tax ID # of subject property: R # Geo ID#:
Tax ID # of subject property: R # Geo ID#:
Tax ID # of subject property: R # Geo ID#:
Addressing Verification Request
Accepted By:
Date Stamp: