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,),, 6 ADDRESS REQUEST B LLJ
V JEFFERSON COUNTY PERMIT CENTER FEB 2 8 2008
( 3.1 621 Sheridan, Port Townsend, WA 98368 (360) 379-4450
APPLICANT: Please fill out item 1 through 8. Fee as per Jefferaas t g f❑
cAV1. New Address U Correction g p 7EFT � ft R t*e
/ ❑ Change [Review DIFF LEIt R1GIT DIFF
g 2. Applicant Name: (QG r-b E I , r II
3. Mailing Address: 1 131 SDHL.,-AM/c,___
Town/State/Zip q o , (.l, (i B 1
4. Telephone: Warr 206-103-x}-.}s +?ome2ch-77c`, ri
C.-CLL.- -
5. Location: Attach a Detailed Drawing or Map.
Additional Fees May Be Required if More Than One
Site Visit Is Necessary
*******PLEASE FLAG YOUR DRIVEWAY.*******
Date Flagged:5/I /rig Flagging Color punk_.
Nine Digit Tax Parcel Number (jb( L4
Plat Name Block Lot
6. Road Name: S lQf-a ( aLC(
Is this a PRIVATE or COUNTY road? CIRCLE ONE
Nearest Cross Road:
7. Neighbors'Address if Known:
Name/Address: 22-1 St�►'✓t:. l ((1.i
Name/Address:
8. Do You Nee C,Construct a Driveway?
YES or� . "IRCLE ONE
9. V s- yis Submitted With A Building Permit? FIELD NOTES
`YE /or NO CIRCLE ONE
. I �
SIIADEll AREAS'4FICE USE ONLY
New Address: PP
Postal District: 1 (( — (r. V
Real Milepost: Road #: i)jC.
Left Right Firc District (y . ;• ,
o�
Budding Permit# Plate Sent ') /`�, `
Odd Even Date Paid / �r'/ Check ' Receipt# , $Date in Computer3/3 /C)
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JEFFERSON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT
ADDRESS REQUEST INSTRUCTIONS
o Complete the address request form in as much detail as possible. The most important
information to include is the complete name of the road where your property is located,
whether or not the property is in a plat, the nine digit parcel identification number and
the block/lot number. The fee is $ jto=
o You must also attach a vicinity map or drawing.
o Use the survey ribbons provided to flag both sides of your driveway. If your driveway is
not in yet, mark the location where the driveway will be. You must apply for a road
approach permit if your driveway will connect with a county road.
o The address technician from the Permit Center will assign your address within 5 working
days. The technician will visit the site and determine the address according to the
nearest milepost distance from the start of the road.
o The red address plate will be sent to your current mailing address, as indicated by you on
the address request form, within one week to ten days. The plate is to be posted at the
end of your driveway and is to be clearly visible from both directions.
o The Permit Center will notify the appropriate postmaster, fire district and emergency
services of your new address.
********.*******************************************
ROAD APPROACH INSTRUCTIONS
o If you are constructing a driveway that will connect with a county road, you must apply for
a road approach permit. The fee is $
o To complete the application for the permit, you will need to indicate the nature of work
and to include a simple sketch of the proposed work. You will also receive a survey
ribbon to mark the site.
o Once the permit inspector has visited the site, a permit will be drawn up and will include
the general conditions as well as any specific requirements concerning your site.
o The permit will be sent to you for you to read and sign. You are then asked to return the
permit to the Permit Center for the permit inspector to sign. You will receive a copy of the
signed permit. The permit is valid for a period of one year.
IF BOTH THE ADDRESS REQUEST AND THE ROAD APPROACH PERMIT IS APPLIED FOR
AT THE SAME TIME, THE TOTAL FEE $ PAD--
If you have additional questions, call the Department of Community Development at(360)379-4450.
h:1home*lncntr'infodpwlinstruct.doc 1/1/05
• . , _02/19/2008 11:43 3603794451 JEFF CO PERMITCENTER PAGE 15/15
APPLICATION FOR ROvA°5OACH PERMIT
Jefferson Count Y > k-b.pets ot-EaIA $T` permit f, :..,,,. ..
Department of Community Development ----_` . Reeeipti; , ':
621 Sheridan Street ctibek i ., �' 1'r'
Port Townsend,WA 98368 Dete':Prl
.... .......
(360) 3794450 or 1-800-831.2678
APPLICANT PLEASE PRINT OR p R TYPE ALL INFORMATION -CHECK BOXES THAT APPLY
BResidential/Private I--.,.1 Logging Approach t=1 Temporary
Commerical Approach ED Improvements Only El Address/Residence
County Road Na t E'rr0, T r tx.r/ C .r,v""f C, mi1@ 1'r'* iy4,
P rend/ rb iCa,til 'ciityy ,
C e7- of c -( 7Pa�r/t �purt 1A-4_4y I hereby designate
Applicant or Authorized Represen tive (Contractor) g.pat ) to act as my agent In matters related to this
Contractor Llc.fl -- - J i I ////application for permit(s).
I ,
I \ ( I . IV 9yj
Melling Address EB 2 8 2008 Owner Si"nature Date
(A-{((k UV c? 3f `2_--z__ 0C)( ; z_zi CO3S'
City-State-Zip Code 0 N Parcel Number
f (IL JEF1fRSi DCD s(_` 4111-0- S�v�y (A,Ilk A-61(S
2_c6 7ZL . f �l�c
Telephone No. Flagging Color&Date
246- 704 '-17 q Z (e e fl)
ACKNOWLEMBMENTS
Bysighingtheapplicationform,thenpplicentatteststhattheInform ationprovided •rein Is true and correct to the best of their knowledge
and agrees to al coddkle rs on the permit. I alga certify that this nppllattlen is being ado wlih the full knowledge and consent of all avneis
of tho affected property, Any metert nl falsehood oranyomissloq'of material fact made, the applicant/owner with respect to this application
packet may ronultIdthis pomtit being null end void /
/
I further agree to sate,Indemnify and hold harmless Jefferson County against all Ilabillties,Jo ont,court costs,reasonable attorney's lees
and expenses which may in any way aeo e against feffesoh County as a result of or in consequ ce of the granting of this permit.
r
I further agree to provide access and right of entry to Jeff son County rind Its employees,ropreson.. tes or agents for the solo purpose of
application review and any required inter inspection. right of entry shall expire when the County -• otudonthe application has complied
with All appileablo laws and regulations. Access and r of entry to applicant's property shall be rogue- ed and shall occur only during
regular business hoots. /
f
The action or actions Applicant wit undertake ns :iesult of this penult may negatively Impact upon one or more reatoncd or endangered
species and could lend to a potential"take"of an- deagerod species as those terms are defined In the federal In now!as the"Endangered
Species Act"or"ESA." Jefferson County make* o rusurances to the appicant that the actions that will he undone , because this permit
has boon Issued will not violate the ESA, Any I divldual,group or agency can file a lawsuit on behalf of an endengero. peeler regardingyour
nctlorfs)even If you aro In compliance with th, Jeffemm County f telopmentcode
The Applicant eclat owlet5oS that nacho or holds Individual and non-transferable responsibility for adhodngto and corn. ng with the ESA.
The Applicant hattt lead this dleclalmer. d girl and dates It below.
IAPPLICANT CR AIim"-1ZED REPRESENTATIVE SIGNATURE) (PAIR)
— - ,.L Qd k W �-{ _
32 j2_ kW jf.,,S (qoUnt .4- -
Updated 12/19/01
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Map Output Page 1 of 1
ArcIMS HTML Viewer Map
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FOR INFORMATIONAL PURPOSES ONLY-
Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respec
correctness or validity. Data contained in this map is limited by the method and accuracy of its collection. Thu Feb
12:04:17 2008
http://gisserver/servlet/com.esri.esrimap.Esri map?ServiceName=ovmap&ClientVersion=4.... 2/28/2008
Address Database Comparison Page 1 of 1
Enter Street Name String: Or Enter Parcel Number
Gal
PUBLIC WORKS DB ADVANTAGE DB ASSESSOR DB MASTER
ADDRESS PARCEL ADDRESS PARCEL ADDRESS PARCEL ADDRESS PARCEL
207 SIERRA TRAIL 601324001 207 SIERRA TRAIL RD 601323002 0 SIERRA TRAIL 601321007 No Addresses Found
267 SIERRA TRAIL 601324003 207 SIERRA TRAIL 601324001. 207 SIERRA TRAIL 601324001
287 SIERRA TRAIL 601324007 267 SIERRA TRAIL 601324003 287 SIERRA TRAIL 601324007.
477 SIERRA TRAIL 601321011 287 SIERRA TRAIL 601324007. 477 SIERRA TRAIL 601321011.
525 SIERRA TRAIL 601321005 477 SIERRA TRAIL 601321011 525 SIERRA TRAIL 601321005
525 SIERRA TRAIL 601321005
For an address search, leave the parcel field blank.This is the signal that you want an address search. For a parcel search, enter the
nine digit parcel number. During a parcel search it does not matter what you have in the address box.
This tool uses a "fuzzy" search so if you enter"ZELATCHED"you will get all addresses that have that word in it. If you enter
"ZELATCHED POINT RD" you will only get the addresses that have that exact sequence of characters in it. This should allow you to
identify the source of many of the discrepancies between the data sources. For instance, searching for"AZALEA LN" gives only 5
addresses in the Advantage DB. Searching for just"AZALEA"adds another address because one was entered incorrectly as"AVE".
I purposely did not make a street picklist so you can have flexibility in your searches.
The far right column is the final list of addresses that will be loaded into the AS400. Clicking on the
address field will give you details about the address. On the details page you can click on links to get a map of the road or search
for more addresses on the parcel. Addresses that have a parcel that is not on our parcel map will not show up on this list as a
hyperlink.
There are many "dummy"addresses In the Advantage DB. Most of these have been filtered out by checking for a blank street
address number. The Assessor DB has been filtered by checking for null in the street address number field.
Letme.know if this tool is useful and/or how it can be made more useful.
http://www.co.jefferson.wa.us/IDMS/DEVTEST/address.asp?street=sierra+trail&parcel= 2/28/2008
. Map Output Page 1 of 1
ArcIMS HTML Viewer Map
FOR INFORMATIONAL PURPOSES ONLY-Jefferson County does not attest to the accuracy of the data containe
and makes no warranty with respect to its correctness or validity. Data contained in this map is limited by the met!'
ccuracy of its collection. Wed Feb 27 14:30:49 2008
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