HomeMy WebLinkAboutADD - OTH Address Requests - 11/22/2005 - • - -- � • w•Ivv vV°°°GI
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Address Request Form
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PO Box 186, Shelton WA 98584
Genie McFarland, Addresser, '(360) 427-9670 ext. 291
There is a $140.00 fee for all.new addresses issued.
Please allow```����y5,,,��_ to 10 working days for processing
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Name:
Phone: 3 C i
Mailing Address:
Street
City State Zip
Parcel Number:
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D Legal Description: �_____�1 Ire �.�n k.
Please draw a diagram of your property including the nearest existing county or
private road and nearest existing address. Keep in mind that we physically visit most
sites. Your proposed driveway must.be clealry marked. Please note any physical
characteristics (i.e. trailer, brush pile, picnic table).
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For official use only below this line
Your New Address Is: 301 0 i CfE j )rt E—
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Important: Please place, within 60 days, your assigned address number at your
driveway location and on your structure. This will allow the most timely service in case
of emergency. In addition, please post the address with the building permit when
construction begins on the site.
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98 Tidemardc�2__bJ Fire bistrict
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