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Builders
/
Land and Mapping
Address Change Request
Change of address for property, structures and/or services.
NOTE: Required fields are indicated in
red
. They must be completed for the Address Change Request to be processed. If you do not have the required information, please obtain it before completing this Address Change Request.
FEES: A fee for address change request may apply. Please see the following link for the ADDRESS ASSIGNMENT section of the Schedule of Charges
(SOC)
. Change will be made upon receipt of payment to Memphis Light, Gas and Water.
Address To Be Changed
Current Address
Reason for Requesting Change
Out of sequence with surrounding addresses
Mail Delivery Issue
Emergency Response Issue
Other (Explain)
Use Type
Residential
Commercial
Multi-Use
(choose only one)
Location Description
Is the lot in a subdivision?
Yes
No
Subdivision Name:
Lot Number:
Parcel ID#:
S/D Phase/Sec/Addition #, etc:
City:
Zip:
Parcel ID#:
Description of
Property Location:
Municipality:
Zip:
Site Plan
Attach surveyed site plan (DWG, TIF, PDF, SHP, GIF, JPG -
DWG preferred
)
Please email AutoCad site plans to Address.assignment@mlgw.org
We will process your request upon receipt of drawing file(s).
Requestor (Owner Representative) Information
Your Company:
Owner Email:
Contact Phone:
Contact Cell:
(e.g., 901-555-1234)
Contact Fax:
Contact Email:
Owner/Responsible Party for Property/Address
Owner Name:
Contact Name (if different from owner):
Company Name (if applicable):
Address:
City:
State:
ZIP:
Contact Phone:
Contact Cell Phone:
Contact Email:
Contact Fax:
Purpose of Address
Choose One:
New Residential House
Additional Residential Meter*
New Commercial Bldg
Commercial Suite/Bay
Barn
Billboard
Cable Equipment
Cell Tower (Tower Owner)
Cell Service Provider
(Co-locate on Tower)
Clubhouse
Fire Pump
Fire Evacuation System
Garage/Detached Dwelling
Gate
Guard House
HSE Meter
Irrigation
Laundry Facility
Leased Outdoor Lighting
Mail Kiosk
Project Address
to be used during construction
Property Address
Pool
Sewer Lift Pump
Sign
Telephone Equipment
Well
OTHER (Explain below)
Special Instructions
Enter security code from above:
Builders
Builder Services Center
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