HomeMy WebLinkAboutOTH Address Requests - 1/25/1993 oN-STAT`��� DEPARTMENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
o a o N P.O. Box 578, Shelton, WA 98584
} o N 2 Genie Pettit-Addressing, Ext. 291
N y y Please allow 5 to 10 working days.
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1864
=Addressequest Form
Name:
l� Last First
Current Mailing Address: `7%j (b,, i- -447
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Street Cit �
Y State Zip Cj81640
Day or Message Phone: _� /�,�o
(� Parcel No:
Legal Description:
Please draw a diagram of your property including nearest existing named road
and
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.
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FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is: (1)q
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IMPORTANT: Please place, within 60 days,
Your assigned ress number
conspicuous location on your structure if visible from the named droad; or at thenparincipal
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: -r-I.n J;� Answered: