HomeMy WebLinkAboutOTH Address Requests - 12/31/2016 $173.50 FEE WILL BE APPLIED
DEPARTMENT OF COMMUNITY DEVELOPMENT
ADDRESSING DIVISION
PO Box 279,Shelton WA 98584
(360) 427-9670 ext. 281 &284
I N 5 4
pi c6 0-84 R�'-RLk4J'\�4t"d PHONE: (34of NAME:.30k, , Le;-S�-e,�
MAILING ADDRESS: 12 CITY: STATE: i I ZIP:
PARCEL NUMBER: 0 00 I
LEGAL DESCRIPTION:
PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY.WHICH SIDE OF THE ROADWAY YOU WILL BE BUILDING ON IF THE
ROAD INTERSECTS YOUR LAND.ANY ADJACENT ADDRESS YOU ARE AWARE OF AND SIMPLE DIAGRAM OF WHERE YOUR
DRIVEWAY WILL BE LOCATED ON THE PARCEL.
1 c, cci +-wvv�
(41
,gRT�
CIA A
SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS: S4,Do SE: L
RECEIVED/e' LOGGED IN TIDEMARV-�' FIRE DISTRICT
BILLED PAID RECPT (.0
00 ri 31