NO PERMIT NUMBER (2) arn
City of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
CITY OF Telephone: (408)777-3228
CU PE t�T I N O FAX: (408)777-3333
BUILDING DEPARTMENT
OFFICIAL NOTIFICATION OF NEW ADDRESS ASSIGNMENT
TO: All Agencies
FROM: City of Cupertino
DATE: February 08, 2008
• RE: Address assignment
Please note the following address assignment. The new address for the construction
trailers on the City of Cupertino's right of way on Mary Ave will be 10755 Mary
Avenue. This will be a temporary address for the duration of the Mary Avenue Bridge
project. Please update your records accordingly. Please see attached map.
The new address will take effect immediately. If you have any questions, please call
me at (408) 777-3246.
Sincerely,
Susan Winslow
Administrative clerk
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Community Development Department
City of Cupertino
• 10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
NEW ADDRESS
ASSIGNMENT FORM
DATE:
NAME (please print):
TELEPHONE NUMBER VGIYIrfi1M `1 YJ-s em It"-{ 27 2 (pQ 0 0 3
APN: (I 1�
NEW ADDRESS: d r'
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• The new address will be assigned using the following criteria: V)61
1. The new address will not create confusion.
2. The odd/even addressing system will be maintained.
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 $306.00 (per hour). 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
Revised 10/16/02
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