To secure an address for a property, please fill out the form below. (You must have an address before you receive a building permit). If you need clarification or have questions, feel free to contact the Township office at: 269-327-0462 or visit us at 7510 East Q Ave. The fee is $35.00

ADDRESS REQUEST FORM

(Fee $35.00)

DATE:____________________                                                PARCEL I.D. NUMBER__________________________________

OWNER:______________________________  OWNER ADDRESS:___________________________________________________

PHONE NUMBER:______________________

THE LEGAL DESCRIPTION OF THE PROPERTY:__________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

DESCRIBE LOCATION OF MAIL BOX ON PARCEL:__________________________________________________________________________

__________________________________________________________________________________________________________

TOWNSHIP USE-PLEASE DO NOT WRITE BELOW THIS LINE

REVIEWED BY OFFICIAL:___________________    DATE:________________       FEE PAID: ($35.00)____________

SENT TO PREIN &NEWHOF:____________________(FAX) 269-372-3411

CONFIRMED NEW ADDRESS ASSIGNED_________________________________________________

PAVILION TOWNSHIP: 7510 EAST Q AVE., SCOTTS, MI 49088   PHONE: 269-327-0462 FAX: 269-327-0098

FAX TO PRIEN NEWHOF