Address Assignment Form

Address Assignment Request

Use this form to request an address assignment for property within the Town of Lapel’s planning jurisdiction.

Please contact the Planning Administrator before applying

The Planning Administrator can confirm whether an address-assignment request is needed and explain any supporting property information, documents, fees, or related approvals that may be required.

Email: planadmin@lapelindiana.org

Before completing the fillable PDF

1. Click Download Fillable Request Form.
2. Save the PDF to your computer or device.
3. Open the saved file using Adobe Acrobat Reader or another PDF application.
4. Complete the required property, owner, and applicant sections.
5. Save the completed PDF again.
6. Print all three pages for the required signatures and notarization.

• The street on which the property is located
• Parcel identification number for each included parcel
• Subdivision name, when applicable
• Total project size in acres
• Related Rezone/PUD or variance case numbers, when applicable
• Related preliminary or final plat information, when applicable
• Property-owner name and contact information
• Applicant name and contact information if the applicant is different from the owner

Prior or related cases

Include any related Rezone/PUD, variance, preliminary plat, or secondary plat case information. Select “Not applicable” on the form if there are no prior or related cases.

Signatures and notarization are required

The applicant affidavit on page two must be signed and notarized.

The property-owner affidavit on page three must also be signed and notarized.

Do not sign either affidavit until you are in the presence of the notary.

All property owners must consent

A signature is required from every party having an ownership interest in the property. If a property owner cannot sign the application, a separate notarized statement from that owner acknowledging and consenting to the request must be included.

1. Contact the Planning Administrator and confirm the current requirements.
2. Complete all required sections of the Address Assignment Request.
3. Obtain the required applicant and property-owner signatures and notarization.
4. Gather any property or project materials requested by the Planning Administrator.
5. Submit the completed request, supporting materials, and any applicable payment to the Planning office as directed.

Planning Office

Town of Lapel Planning
1011 Main Street
Lapel, Indiana 46051

Email: planadmin@lapelindiana.org