HomeMy WebLinkAboutOTH Address Requests - 3/2/1993 DEPARTMENT OF COMMUNITY DEVELOPMENT-PLANNING DIVISION
P.O. Box 578, Shelton, WA 98584
Genie Pettit-Addressing, Ext. 291
There is a $5.00 fee for all new addresses issued. ^,r
Please allow 5 to 10 working days.
Address Request Form
Name: Jnh✓o(fn John
Last First M.I.
Current Mailing Address: 11E L. �gS B
13(� m I�551 cm. C��� �� �-� —,1�y
Street City State Zip
Day or Message Phone: ( ) a 5 - 41 a 34
Parcel No: Q o'/3/• q1c) /0 /a /Z�
Legal Description: i r;. CZ O4 z'
,moo j n� I -rrz c,
draw a idiagrand'of your jaroperty including te-arest axisrhig--narned road and nearest
"fi='k'existifi address. Draw•' otir house'and dmidw '
3 Y ay;indicate rTbrthexiy direction. ��l$ase have '
your drivewaysigned or•marked for.eW.identification.,.All above in mmation is required
to process-your request. .� .._._
dross �onn n E 1, 19 3 m 1 6�>)UyY CAZZX
FOR OFFICE USE ONLY BELOW THIS LINE
Your New Address Is: n E 1 j 15 m It6IL 1 u-x _�ROQC I
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: 13 Issued:��3 Entered:A a �/., Answered: a �1�