{"id":266,"date":"2016-08-02T13:26:22","date_gmt":"2016-08-02T17:26:22","guid":{"rendered":"http:\/\/www.coshoctoncounty.net\/engineer\/?page_id=266"},"modified":"2016-08-02T13:34:38","modified_gmt":"2016-08-02T17:34:38","slug":"address-application","status":"publish","type":"page","link":"https:\/\/www.coshoctoncounty.net\/engineer\/address-application\/","title":{"rendered":"Address Application"},"content":{"rendered":"\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f264-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"264\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/engineer\/wp-json\/wp\/v2\/pages\/266#wpcf7-f264-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"264\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f264-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<h3>Contact Information\n<\/h3>\n<p>Applicant Name\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"name1\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"name1\" \/><\/span>\n<\/p>\n<p>Current Address\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"current-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"current-address\" \/><\/span>\n<\/p>\n<p>City\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"current-city\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"current-city\" \/><\/span>\n<\/p>\n<p>ZIP\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"current-zip\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"current-zip\" \/><\/span>\n<\/p>\n<p>State\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"state\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"state\"><option value=\"OH\">OH<\/option><option value=\"AL\">AL<\/option><option value=\"AK\">AK<\/option><option value=\"AZ\">AZ<\/option><option value=\"AR\">AR<\/option><option value=\"CA\">CA<\/option><option value=\"CO\">CO<\/option><option value=\"CT\">CT<\/option><option value=\"DE\">DE<\/option><option value=\"FL\">FL<\/option><option value=\"GA\">GA<\/option><option value=\"HI\">HI<\/option><option value=\"ID\">ID<\/option><option value=\"IL\">IL<\/option><option value=\"IN\">IN<\/option><option value=\"IA\">IA<\/option><option value=\"KS\">KS<\/option><option value=\"KY\">KY<\/option><option value=\"LA\">LA<\/option><option value=\"ME\">ME<\/option><option value=\"MD\">MD<\/option><option value=\"MA\">MA<\/option><option value=\"MI\">MI<\/option><option value=\"MN\">MN<\/option><option value=\"MS\">MS<\/option><option value=\"MO\">MO<\/option><option value=\"MT\">MT<\/option><option value=\"NE\">NE<\/option><option value=\"NV\">NV<\/option><option value=\"NH\">NH<\/option><option value=\"NJ\">NJ<\/option><option value=\"NM\">NM<\/option><option value=\"NY\">NY<\/option><option value=\"NC\">NC<\/option><option value=\"ND\">ND<\/option><option value=\"OH\">OH<\/option><option value=\"OK\">OK<\/option><option value=\"OR\">OR<\/option><option value=\"PA\">PA<\/option><option value=\"RI\">RI<\/option><option value=\"SC\">SC<\/option><option value=\"SD\">SD<\/option><option value=\"TN\">TN<\/option><option value=\"TX\">TX<\/option><option value=\"UT\">UT<\/option><option value=\"VT\">VT<\/option><option value=\"VA\">VA<\/option><option value=\"WA\">WA<\/option><option value=\"WV\">WV<\/option><option value=\"WI\">WI<\/option><option value=\"WY\">WY<\/option><\/select><\/span>\n<\/p>\n<p>Email Address\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-text wpcf7-validates-as-email\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"email\" \/><\/span>\n<\/p>\n<p>Applicant Phone No\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone-no\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"tel\" name=\"phone-no\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"phone-type\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"phone-type\" value=\"Home\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Home<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"phone-type\" value=\"Work\" \/><span class=\"wpcf7-list-item-label\">Work<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"phone-type\" value=\"Cell\" \/><span class=\"wpcf7-list-item-label\">Cell<\/span><\/span><\/span><\/span>\n<\/p>\n<h3>New Structure Information\n<\/h3>\n<p>Proposed Building:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"propbldg\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"propbldg\" value=\"House\" \/><span class=\"wpcf7-list-item-label\">House<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"propbldg\" value=\"Mobile Home\" \/><span class=\"wpcf7-list-item-label\">Mobile Home<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"propbldg\" value=\"Business\" \/><span class=\"wpcf7-list-item-label\">Business<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"propbldg\" value=\"Other\" \/><span class=\"wpcf7-list-item-label\">Other<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Township\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"township\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"township\" \/><\/span>\n<\/p>\n<p>Road Name\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"road\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"road\" \/><\/span>\n<\/p>\n<p>Property Owner\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"prop-owner\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"prop-owner\" \/><\/span>\n<\/p>\n<p>Adjacent neighbor's addresses and mailbox locations (same side as property or across the road)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"adjacent-addresses\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"adjacent-addresses\" \/><\/span>\n<\/p>\n<p>Notes\/Comments\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"comment\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"comment\" \/><\/span>\n<\/p>\n<ul>\n\t<li>\n\t\t<p>The address will be assigned based upon the location of the approved access point.\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>All driveways will be evaluated for the appropriate permit requirements.\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>Applicant will indicate the approximate location of the structure being addressed.\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p><b>The address will not be assigned until access has been approved.<\/b>\n\t\t<\/p>\n\t<\/li>\n<\/ul>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Send\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":52,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-fullwidth.php","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-266","page","type-page","status-publish","hentry","post-preview"],"_links":{"self":[{"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/pages\/266","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/users\/52"}],"replies":[{"embeddable":true,"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/comments?post=266"}],"version-history":[{"count":1,"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/pages\/266\/revisions"}],"predecessor-version":[{"id":268,"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/pages\/266\/revisions\/268"}],"wp:attachment":[{"href":"https:\/\/www.coshoctoncounty.net\/engineer\/wp-json\/wp\/v2\/media?parent=266"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}