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PUBLIC WOMAK5 <br />Building Type: C_x, <br />Address Application <br />^c R LiNew F�Jerify I iPreliminary (future) <br />Please complete mmmbereditems(I-7)and submit bye -mail to: mhaley@ci.everett.wa.us Call 425-257-8813 for other options. <br />1. Relationship to owner: Ay rA4 Date: ;•l0•I� <br />2. (a) Your name and mailing address: (b) Phone: (c) e-mail: <br />2e,_J;5, 644-4Ave- NW 42587� b�i1 CfGtlj �{kI' <br />OLIthOfAnr7LJ�{o(,L.OM <br />5+aawood WP 10VOt, <br />3. Date needed (please allow up to 4 weeks for assignment or verification): <br />4. Primary address application: ?60',1 F—I Avc X f vere.* lvI) <br />5. Supporting information and current use of prim ry address (licenses, marketi ,r, etc.): <br />feLort�i � <br />5t,ovl 36oL Earl Ave home po•y•iel >60S <br />C;{Y <br />04er rccards, )how 3603 <br />6. Site plan attached (recommended to expedite request): <br />7. (a) Owner name and mailing address: (b) Phone: (c) e— <br />mail -Ken fie•fh v GY�+h:ct tAAr+fn ifZ5-3'08-4253 <br />3608 Gael Av4 ;Pf- <br />Evere-ft- W A 45201 <br />Date: <br />Current Parcel Address: <br />FOR OFFICE USE ONL Y <br />Suggested Parcel Address: <br />Owner written approval to revise parcel address received: <br />Owner written approval for city proposed address received: <br />COE Master Address: <br />Go Sync GIS Map Address: <br />Microfiche: <br />Utility eillilig: Zk Llrc4y.C� <br />Unna 3 6 n & F+ i <br />�(�o g �r�rl ►� <br />Permit Servic, %: <br />Field address verified with photo: <br />Application form available online at http://www.everettwa.orgl_qqt_,PDF.aspx?pdflD=5448 <br />;Yes/No <br />Ve <br />cog No.: <br />❑ Yes / No ❑ <br />❑ Yes / No ❑ <br />k� <br />IJ Yes / No ❑ <br />Updated 2/23/2012 <br />