HomeMy WebLinkAboutADR2008-00096 I, —
ADDRESS REQUEST '____�r
JEFFERSON COUNTY PERMIT CENTER' MAR 1 2 2
621 Sheridan, Port Townsend, WA 98368 (360)379-4450
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PPLICANT: Please fill out item 1 through 8. Fee as per Jefferson County Fee Schedule
1. % New Address ■ Correction ■ Change ■Review Mai E 1, E
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2. Applicant Name: `j014 p,{ 14
3. Mailing Address: 4 c 11 E/'G� �,,, f /ZD
�„, 4 ygg)..c Town/State/Zip l / / w . ..
4. Telephone: Work Home: 3C-W ?32.771
IIII5. 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:3 tic / by", Flagging Color ,�„t%
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Nine Digit Tax Parcel Number —721 n 4-3001
Plat Name Block Lot
6. Road Name: SoLcA-14 Po,ILA s
Is this a PRIVATE or COUNTY road? CIRCLE ONE
Nearest Cross Road: ill-O Q ki t f1Yt<
7. Neighbors'Address if Known: / {
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Name/Address: tI-
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Name/Address: i'
8. Do You Nee To Construct a Driveway? s pin
YES or CIRCLE ONE --
9. Was This C itted With A Building Permit? i t �
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YES or(O CIRCLE ONE
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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 $ --
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
clays. 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 $ j3(1^
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 $ i3(
If you have additional questions, call the Department of Community Development at(360)379-4450.
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