Online Request for Utility Addresses

2. Please allow for 5 to 10 Town business days for processing.
4. What type of permit is associated with the address?*

   1. Electrical
   2. Irrigation
   3. Sign

   1. Construction Tailor
   2. Network Nodes
6. Is the address temporary or permanent?*
   -- Select One --TemporaryPermanent
8. Does it need to be an E911 address?*
   -- Select One --YesNo

   An E911 address is a location that would require Police or Fire response.

10. If you said yes, does it need to be mapped in GIS?*
    -- Select One --YesNo

    The Town will require an address exhibit is PDF and CAD for mapping.

12. Upload a document showing the location of the address assignment.*
14. Name of Contractor*
16. Phone
17. Email
19. Name of Owner*
21. Phone
22. Email
24. For address inquiries, please contact:

    Data Team
    Information Technology Department at 972-569-1178

Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field