COUNTY OF HUMBOLDT
PLANNING
AND
BUILDING DEPARTMENT
STREET ADDRESS APPLICATION
All residences and certain other buildings shall be numbered in accordance with Chapter 2, Section 442-7 of the
Humboldt County Code. The Planning and Building Department cannot assign addresses to wells, vacant lots, or
proposed lots. Addresses will be assigned only to structures for which a building permit has been issued.
STEP 1: Applicant Information
Please provide as much information as possible. Street address applications require a signature of the property owner.
Applicant:
Mailing Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Street Name:
Nearest Cross Street(s):
Closest City:
Assessment Parcel Number:
Current Street Address on Parcel (if any):
If Change of Address Give Reason:
Signature of Property Owner:
Date:
Print Name of Property Owner:
Owner Address:
(if different from above)
STEP 2: Plot Plan
Submit a plot plan or sketch in the area provided on page three of this application. Instructions and an example are
provided.
STEP 3: Fees
Make payment and mail application to:
Humboldt County Planning Division
3015 H Street
Eureka CA 95501
Address Assignment
$65.00 each
Total
$
Address Change
$50.00 each
Total
$
Address Verification
$30.00 each
Total
$
(maximum $325 for five addresses or more)
OFFICE USE ONLY
Rec’d by:
APPS #
Bldg. Permit Req’d?
Yes / No
Bldg. App #
New Address:
Letter Complete
AP Book
OnTrack
LIS
Multi-Situs
THIS PAGE INTENTIONALLY LEFT BLANK
DRAW SKETCH OR ATTACH PLOT PLAN HERE
Provide a plot plan or sketch showing the structures for which this application is being submitted. Show the location of
the driveways and access back to a main road including road names and nearest cross streets. Please also show
other structures which have existing addresses, and the approximate distances (in feet) from the structure to all
property lines and roads. Please include neighboring addresses if available. If the property abuts more than one road,
please indicate which direction the front of the structure will be facing. For additional guidance, see sample plot plan
following this page.
Ü
Attach additional pages if necessary
SAMPLE PLOT PLAN
FOR NEW OR CHANGE OF ADDRESS
Provide a plot plan or sketch showing the structures for which this application is being submitted. Show the
location of the driveways and access back to a main road including road names and nearest cross streets.
Please also show other structures which have existing addresses and the approximate distances (in feet)
from the structure to all property lines and roads. Please include neighboring addresses if available. If the
property abuts more than one road, please indicate which direction the front of the structure will be facing.
For additional guidance, see sample plot plan following this page.
CROSS STREET
Assessor Parcel #
Proposed New Address
Front of Structure
545
CROSS STREET
560
540
Neighbor's Address #
Ü
Main Road
ANY STREET
Current Address if Applicable
555
distance (ft)
Neighbor's Address #
distance (ft)
APN: 555-121-003