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�c�s�yes... ro ryt.c <br />xirr rns cotngW <br />Contact Name <br />Mailing Address <br />KXWWXTAS COUNTY <br />DEPARTMENT OF PUBLIC WORKS <br />Private Road Name Application: $400.00 <br />Payment Method: ❑ Check ❑ Cash <br />Phone Number <br />Parcel Number <br />Signature <br />PROPERTY OWNERS SERVED BY PRIVATE ROAD: <br />Name: <br />DATE STAMP <br />Signature: <br />Parcel Number: <br />Name: <br />Signature: <br />Parcel Number: <br />Name: <br />Signature: <br />Parcel Number: <br />Name: <br />Signature: <br />Parcel Number: <br />Name: <br />Signature: <br />Parcel Number:! <br />PROPOSED ROAD NAME: <br />All road names will be limited to 13 characters with spaces. Suffixes will be abbreviated. Road names shall not <br />start with a number. Example: Three Queens Loop. Road names shall not duplicate existing road names and shall <br />not have the same name with different suffix. Example. Pacific Ave, Pacific Ln. Pacific Dr. <br />MUST SUBMIT FIVE ROAD NAMES AND A SITE MAP OF THE LOCATION OF THE ROAD: <br />1. <br />3. <br />4. <br />5. <br />When completed, return to: Address Coordinator, Kittitas county Public Works, 411 [forth Ruby Suite 1, <br />Ellensburg, Washington 98926 <br />M <br />