Application for Civic Address Applicant InformationName(Required) First Last Email(Required) Phone(Required)Address(Required) Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Site InformationProperty Roll Number(Required) Official Road Name(Required) Is this a request for a replacement number?(Required) Yes No Nearest Civic Address (Before) Nearest Civic Address (After) Is this part of an entrance permit application?(Required) Yes No