Form
SN-2019-07
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Invoice Number:
Received by:
Florence County
E-911 Addressing
518 S. Irby Street
Florence, SC 29501
843-676-8600
Application for Naming /
Re-naming Street
General Info
We the undersigned property owners/ residents request that the Florence County E9-1-1 Addressing Department, initiate the
necessary steps to name the street on which our residences or businesses abut or will abut.
1. Reason for street name:
2. Location of street to be named:
3. Legal Description:
(Lot, Block, Subdivision Name & Map Number)
Project Title:
We request that this street be named the following: (You must submit at least three choices. Any petitions with less than 3 will
not be considered)
Owner/Tenant/Permit Holder Info
5. Property Owner/Lessee Tenant Name:
Telephone:
Address: City: State: Zip Code: E-Mail Address:
6. Applicant Name:
Check one □
Property Owner □ Authorized Agent of Property Owner Telephone:
Address:
City: State:
Zip Code: E-Mail Address:
I understand the following:
Roads that have been officially named by the Florence County Council may be considered for renaming by the
Florence County Council as necessary, upon the recommendation of the Florence County Planning Commission.
Prior to street names being approved, staff will check the proposed names against the E9-1-I MSAG-{Master Street Address Guide) to
determine if there exist any phonetic similarities to existing street names in all of Florence County. We understand that by submitting this
petition, we are not guaranteed that the request will be approved.
This application must be accompanied by a $100 non-refundable processing fee
Request to rename, filing fee. For any street with an official name, prior to consideration for renaming by the Florence County Planning
Commission, a non-refundable filing fee of $100.00 must be received by the Florence County Planning Office.
Successful applicants will be required to pay an actual-cost sign replacement fee not to exceed $500. These fees are established and are
subject to periodic changes by the Florence County Council. Fee for renaming is to be paid in advance.
Applicant’s Signature Date
Staff Use Only
Planning Commission Date:
County Council Date:
Page 2 of 2 Florence County Street Naming Application
THERE MUST BE 100% PARTICIPATION OF ALL ADJACENT PROPERTY OWNERS AND ALL PROPERTY OWNERS MUST SIGN
THE APPLICATION. YOUR PARTICIPATION RELEASES AND INDEMNIFIES ALL PROPERTY OWNERS FROM ANY DUTY TO
MAINTAIN THE ROAD.
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
Property Owner: Telephone:
Address: City: State: Zip Code:
Signature:
Date:
