HomeMy WebLinkAboutADR2008-00075 _RECE \TED
(cam
ADDRESS REQUEST
"`t o 2T-,3
3 JEFFERSON COUNTY PERMIT CENTER
�
� Seridan,Port Townsend,WA 98368 (360) 379-4450
;ts.rrn 1
411' W
fill out item 1 through 8. Fee as per Jefferson County Fee Schedule
1. 'New Address ❑ Correction ❑ Change ['Review DIFF LEFT M.P. RIGHT DIFF
2. Applicant Name: N<<ax° ^ `' M I
3. Mailing Address: &ox Cr-57-2-
Town/State/Zip Lu cX1 c I 3
4. Telephone: Work (300)€Ll °1361 Home: (z)2.71 -6(73
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: / / Flagging Color KIA
Nine Digit Tax Parcel Number 9' -f OOOO G e)
Plat Name hock \LA 3 Lot I 2-4
6. Road Name: 176(.4-1, (tJ�
Is this a PRIVATE or COUNTY road? CIRCLE ONE
Nearest Cross Road: No..e.,_
7. Neighbors'Address if Known:
Name/Address: kites
Name/Address:
8. Do You Ne- s o Construct a Driveway?
YES or NO CIRCLE ONE
FIELD NOTES
9. Was This T:lilted With A Building Permit?
YES or 009 CIRCLE ONE
SHADED AREAS OFFICE USE ONLY P I
New Address/" 1 q I E f- 8( (
Postal District: PO(± Li 40u1 i)PL&J,.- (C. or-01- e n ► 1 .
is .10 f10�c . ►n}e_C R
Real Milepost: Road#:
Left Right Fire District Building Permit# Plate Sent S it
Or
Odd Even Date Paid 5 / /015 Check# j i 5s Receipt# 7�150 Date in Computee /)9/CrE
:5 vOn aak-I a
An. of
V ,
' .l—v
90 ,,/9219
CIRAWING NI IMF*I
LP—O.3 P.3-23
el.d 4- a ; 6z it
I
till ° 'af k" ;)
4 gx-,- lel 4 f i Cl
' Aaa t.)? o
in i
', 7 i 7 b a I Ap
N e a �.bt`l. 1
zssv> «„ i I I'° V w
N.NAd
N. ': 0
p ,„
6j°w°I Sa.V J 11.- .43 ONN4 ,`>N� .11 t...i3 m wi g'... , / N n
�Z"g i1 x g E n�-� I„mod
aa z Eg 1 ��..::- J
. x a E„ f a , �1 ,, 4 _ ss
ev Vg.. C' 8
i';14.
' a t 011:1„
R 5 a �/`iso� x it •I�, 5d
NJ
Ca
�. 1:13.1 Vi �� cc�ea lei, �,'. . '.�• n
-e. or. _ -...Al,', . V'if
seam v
`o', a,1_ oa.�'t �' W
£sp . 4(
A 43
ih iS;4o4;41VIFItso:: !4
i.
'° iv.xR' e4zi WI 1 r
'* ..f�F 9- ii>gg'33+i4f[ . \\
t i !u s-!=1” a`!i7_t�gt. e U
oft, a k f=?.R:a a0ift?tt6 n 44p 1
E.
:7: � �C?�,A";4 E's'ga m4pRR ?g;': 4asS1x ' UI a 03 "x35-44; FF r CA N a S�i�'°. g74p 6g' ? 0
�' i 3.x .°1di^'Rii.44 S.
01 •..sue'.
. Map Output Page 1 of 1
ArcIMS HTML Viewer Map
IN i
'j i 994v.,tititi\ .,
_ f
_
994642X65 994000035 994606042 1 994000099
__ � 1 994000036 994060030
_ w.y -__ __r'� _ !14699970 994000037∎ I I
s '.994{%}2034, 994690034 �1
�4a9ms2� -- i / r�n990 Legend
{ 99dt10fl631�, 994000099
ti �_.9DA00004,
! 1 ❑ Selected Features
•/ 1,99.10Ci,079_�
. �.. `.,�.{` / Terms
994009030
_9949X'6629_. 1 '''''-•''''''' Q CasxjSmn 1
,/_944t,Y11024 �J4000096 494096710 `'', * Ras*Cameos
99401 21 994000057 99400€0,0
r 9940X;0426_ a r Road System•,.._994ca}t09 • 99407.0066 1..
99400002; 1 I I Paaals+l
994090924 I ,3odndade3
994600023. '
1\
�1 �4000022
' 964000321 {-- 991�666caC7.4
- /
- / 99400665 rf�f+9066os5 r1 Caroms
,/'
99400:x220 994000070 "'
9q, ,:7 / °'
xwola �
ssre+Xtdoi 7. 9Ha000064 r
94 x?0,ti ? 994000957
sXt7ilCtXY,5; 99400027, / 4rk7CGY`4 -
777 r 9440053W-
,
49.4MYd,4� . . 994666068
s+4s1640')i3 1 994MX087 £
l I XXXt:2i I 994900072 i' 994000063 9940SX.%76245400008I f
+d,- .?4sm Cwr.,,
c -tom'avix!,,GIS _._{ ( /0, ' 9$q 549940X}0062
FOR INFORMATIONAL PURPOSES ONLY-
Jefferson County does not attest to the accuracy of the data contained herein and makes no warranty with respect to its
correctness or validity. Data contained in this map is limited by the method and accuracy of its collection.Thu May 08
10:57:36 2008
http://gisserver/servlet/com.esri.esrimap.Esrimap?ServiceName=ovmap&ClientV ersion-4.0... 5/8/2008