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ADkn^Wt3 <br />DEPARTMENT OF COMMUNITY DEVELOPMENT <br />(r2l Shetidan Street, Port l'orvnsend, WA 98368 <br />Tel: 3(r0.379.-l.l5t) | Fax: i60.379.4451 <br />\{'eb: s,n'w'.cr-l.iefferscrn.wa.us/conrmrrnitldcvclc,prnent <br />Ii-rnail: dcd(Ec<i.iet fersr.ln.u'rr.us <br />NEW ADDRESS APPLICATION <br />Steps in the Permit Process: <br />-Review required submittal items to ensure all information is completed prior to submitting application. <br />-Fees will be collected at intake. Additional fees may apply after review and payment is required before permit is issued <br />New Address Correction Change <br />{ New Drivewa must be fla with fla tn ta received from <br />n <br />r:t-ho-0 <br />Related A lication #s <br />For Department Use Only Receipt # <br />ent #: <br />FOR OFFICE USE ONIY <br />DIFF <br />Road database entry:Post OfficeTidemark Entry: r',|)-lUfi <br />NotesLEFT M.P. RIGHT DIFF <br />DateNew Address:g <br /># <br />lates mailed <br />P lnformation <br />Assessor Tax Parcel Number: <br />Parcel Address (if applicable): <br />Directions to Property: <br />City PORT TO!\NSEND <br />977100421 <br />64 DISCOVERY CREST <br />Name of street(s) from which access will be gained <br />ts this a private road? @v"t F*o <br />Neighbor's Name & Address, if known: <br />Do you need to construct a driveway from road onto your property? <br />County or State Permit #: <br />DISCOVERY CREST <br />MICHAEL ROSS; PARCEL 002244007 <br />No <br />Cross Street coMBS sr <br />$v.t <br />Name/Address: <br />Name/Address: <br />ROAD APPROACH OR STATE HWY ACCESS PERMITS ARE REQUIRED IF YOUR DRIVEWAY IS OFF A COUNTY OR STATE <br />ROAD lN ORDER TO PROCESS ADDRESS REQUEST. Please contact Public Works at (360) 385-9160 with questions. <br />o State: WSDOT http://www.wsdot.wa.gov/Northwest/DevelopmentServices/AccessServices.htm or (360) 757-5961 <br />o County: https://wa-jeffersoncounty.civicplus.com/445/Ri$ht-of-Way-Permits-Vacations otEqqllt!4qq <br />Date: <br />'-!)r.'" 1-r,^6-Y <br />\.lirtss .\1:1,lic:rtxrri I