ADDRESS CHANGEa
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CITY OF
CUPEI�TINO
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City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF NEW ADDRESS ASSIGNMENT
TO: All Agencies
FROM: City of Cupertino
DATE: April 26, 2007
RE: Address assignment
Please note the following address assignment. Parcel 342-63-002 has been assigned a
seperate address for the residence adjacent to Cristo Rey that currently shares the same
address as the general office at Gate of Heaven Cemetery, which is 22555 Cristo Rey Dr.,
Los Altos. The new address for the residence is 22557 Cristo Rey Dr., Los Altos, CA
94024. 22555 Cristo Rey Dr will remain the same. Please update your records
accordingly.
The new address will take effect immediately. If you have any questions, please call
me at (408) 777-3246.
Sincerely,
Susan
Susan Winslow
Administrative clerk
Printed on Recycled Paper
CITY CUPERTINO 160011001
Community Development Departrmnt
C0 ofCupertino
• 10300 Tone Avenue
D elephonc: (408) 777-3228
MAR 1 3 2007 Fax: (408) 777-3333
NEWADDRESS
ASSIGNMENT FORM
DATE: zoo Lg�3733
NAME (please print): C/1RLo S RA S Co
TELEPHONE NUMBER: &SO- H 2-'B- 3? 30 2-Y-r Z11
,APN:
NEW ADDRESS: 22 S 5.7. Cl2 )S`fo RE`( Ute, L 0-S /ALTOS C/�
gy021-�
The new address will be assigned using the following criteria:
1. The new address will not create confusion.
2. The odd/even addressing system will be;tnaintained.
3. The new address will not result in `a'public'safety hazard.
4. PROOF OF OWNERSHIP IS REQUIRED. (Ex. Property tax bill)
The fee for processing a new address request is $268.00. The fee is due with this
request form and will not be refunded if the request is denied.
The direct costs associated with a new address request will be borne by the
applicant. Approximate review time is fifteen (15) days. If the address is granted,
the new address will be in effect thirty (30) days following approval.
Signature
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Revised 10/16/02
. ebruary 10, 2007
• RECEIVED
MAR 2 6 2007
City of Cupertino PUBLIC WORKS DEPARTMENT
We currently have the address of 22555 Cristo Rey Drive, Los Altos, Ca for the general
office at Gate of Heaven cemetery. There is also a residence on the same property
adjacent to Cristo Rey that currently shares the same address. We would like to obtain a
new address so that mail or other packages are delivered to the residence directly.
�Thank you,
Carlos Rascon
General manager
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•RECEIVED BY: SUEW
TODAY'S DATE: 03/26/07
TIME: 15:56
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ADDRESS CHANGE
CITY OF CUPERTINO
RECEIPT NUMBER: BS000000790
PAYOR: CATHOLIC CEMETERIES
REGISTER DATE: 03/26/07
1.000 @ $268.00 $268.00
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TOTAL DUE: $268.00
CHECK $268.00 REF NUM: 205527
TENDERED CHANGE
$268.00 $.00
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