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t Townsend WA 8�8368 3601y®ant
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STOCK PLAN #4
!K Paeocie, de444.4 44 eomftl lGGrj �fr le, TEAL LAKE VILLAGE, LOT 13
Project Description:
NEW SINGLE FAMILY RESIDENCE WITH ATTACHED GARAGE
9 Digit Parcel Identification Number(from your tax statement):
998-700-013
Site Address
911#: 246 Road Name:Crestview Drive Zip Code: 98365
Legal Description
Subdivision Name: Teal Lake Village Block: ( Lot(s): 13
Section: 21 Township: 28N Range: lE
Parcel Size (acres or square footage):
Property Owner: Olympic Real Estate Development, LLC Phone:
(360) 437-2101
Mailing Address:
781 Walker Way, Port Ludlow, WA 98365
Applicant/Occupant: Phone:
(if different from owner) Same
Mailing Address:
Authorized Rep: Phone:
Jeff Evanger (360) 437-2101
Mailing Address:
781 Walker Way, Port Ludlow, WA 98365
General Contractor:
(360) 437-2101
Or Manufactured Home Installer: Phone:
Mailing Address:
781 Walker Way, Port Ludlow, WA 98365
Contractor's State License Number. OLY1 PRE010M8 Expiration
Oate:
0
Septic Designer: Phone:
Mailing Address:
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General Phone:
Parker, Smith & Feek 800-457-0220
Contractor's Bond Holder:
Mailing Address:
1 r
FOR OFFICE USE ONLY
Fire District: - Planning Area School District: t Zone:
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