HomeMy WebLinkAboutOTH Address Requests - 9/28/1993 DEPARTMENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
P.O. Box 578, Shelton, WA 98584
d ' -Addressing, Ext. 291
4er, Is a $5.00 fee for all new addresses issued.
I_ _ stoa_ Please allow 5 to 10 working days.
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Address Request Form
Name:
Last First rr M.I.
Current Mailing Address: w
Street ity State Zip
Day or Message Phone: ( ) 11/14
Parcel No: / % a;�,�/0/a/`r/��
Legal Description: V
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Please draw iagram of your property ' ng nearest exi i named r and nearest
isting a dress. raw your house a drivew • indicat orth ly dir tion. lease have
y ur dri way signe or marked f easy identificat II above i rmation is ired-
t pro ess your request.
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FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is: .�r• I nD I f'Y)(,f��CX.t_��
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: -`ny ssued: Entered:q'OM Answered: I'o
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