HomeMy WebLinkAboutADD - OTH Address Requests ,STATE DEPAR I MENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
o P.O. Box 578, Shelton, WA 98584
A u = Genie Pettit-Addressing, Ext. 291
o T z Please allow 5 to 10 working days.
N Y oy
1864 Address Request Form
Name: CHURCH OF THE NAZARENE
Last First M.I.
Current Mailing Address: 1331 SHELTON SPRINGS RD SHELTON WA 98584
Street - City State Zip
Day or Message Phone: 206-426-1298
Parcel No: / O/ - all -_9/ o/ t /g /cam
Legal Description: 0,
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Please draw a diagram of your property including nearest existing named/road and nearest
existing address. Draw your house and driveway; indicate northerly direction. Please have
your driveway signed or marked for easy identification. All above information is required
to process your request.
FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is:
IMPORTANT: Please place, within 60 days, your assigned address number in a
conspicuous location on your structure if visible from the named road; or at the principal
place of access (driveway entrance) if the house is not visible from the named road. 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.
Received: Issued: Entered: Answered: