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4[Fr7' PUBLIC WOR" <br />Address Application <br />Building Type: isFF_ <br />Please complete numbered items (1 <br />['Verify [—]Preliminary (future) <br />7t and submit by a -mail to: nIha!eY@cJevefett,wa.us Coll 425-257-8813 for other options. <br />1. Relationsh ;� to owner: Date: I p l? I I Z <br />2. (a) Your name and mailing address: (b) Phone: (c) e-mail: <br />DoLL9(u5 Fordkarv) <br />(OWn'r) <br />3. Date needed (please allow up to 4 weeks for assignment or verification): <br />4. Primary address application: lU I3 [ iZ <br />5. Supporting information and current use of prim ry-addeess Ice marketing, etc.): <br />Currcrvt 5FP- �+ ucic�ress o� q5D9 -I TMc s �(vc <br />IS �6. Site plan attac ed (recommended to expedite request): Yes / No <br />7. (a) Owner name and mailing address: (b) Phone: (c) e-mail: <br />Date: <br />FOB' OF jcF U5F ONL Y <br />Current Parcel Address: IzGUse. <br />Suggested Parcel Address: Gi J` D9 --74�� Au< - <br />Owner written approval to revise parcel address received: <br />Owner written approval for city proposed address received <br />COE Master Address: <br />(,o sync GIS Map Address: <br />Microfiche: <br />Utility Billing: <br />Permit Services: <br />Field address verified with photo: <br />5E <br />'.Ql�A 4 O Yes/No ❑ <br />❑ Yes / No ❑ <br />❑ Ye; / No ri <br />Application form available online at http://www.everettwa.org/Get PDr.aspx?pdfI0=5448 uprtawci 212-"iNA: <br />