HomeMy WebLinkAboutOTH Address Requests - 2/4/2009 DEPARTMENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
P.O. Box 578, Shelton, WA 98584
Genie McFarland-Addressing, Ext. 291
There is a $5.00 fee for all new addresses issued.
�r/p Please allow 5 to 10 working days.
Address Request Form \\6\ JAN2G19°9
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Name:
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Last First M.I.
Mailing Address: P- O, 13 o x S o Z 9 4z"" La A g73/ 2-
Street City State Zip
Day or Message Phone: W(3 - 47l� -!.�8 2 o r �� 7 4 2 -05'�;
Parcel No: 2/2-/3/O/�_- 77,Z s2101 Z 12/ 2 2_3 o¢-,27-
Legal Description: L o f S�. o vf�Scu��i� si G�+ / 79 Z
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.
Pie,2Se sere a//erc4 71;;- .
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FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is: 91BI nt DrALd
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:(�-LD Logged In:,,)-4-95 Tidemark 4-�� Answeredt-�)A q9 Fire District -�