OTSEGO COUNTY EQUALIZATION DEPARTMENT
800 Livingston Blvd Ste 1-D
Gaylord, MI 49735
Phone: (989) 731-7410 Fax: (989) 731-7418
APPLICATION FOR STREET ADDRESS
THERE IS A $25.00 CHARGE FOR A PROPERTY ADDRESS
Date
Property Owner
Applicant or
Contractors Name ( )
Fax#
Current ( ) ( )
Mailing Street Apt # Phone # Fax#
Address
City State Zip
Property Code Number 6 9 - - - - -
Is this parcel part of a property split occurring since the first of January?
Yes ___ No ___ If yes, please include date of land division approval
Date
Type of Structure to be Built: (Check one) Approximate Start of Construction
Home Pole Building Commercial/Industrial Date: ______/______/______
Garage Temporary Electrical Tower/Well Site Other _________________
Name of Access Road
Signature of Applicant
BRIEFLY SKETCH PROPERTY BOUNDARIES AND LOCATION OF THE DRIVEWAY
PLEASE INCLUDE DISTANCE OF DRIVEWAY FROM PROPERTY LINES
Example:
Prop Line
Distance
Driveway
Prop Line Access
Road
OFFICE USE: rev.7/06
OFFICIAL HOUSE NUMBER ASSIGNED TO THIS PARCEL:
DATE ASSIGNED: POST OFFICE:
