HomeMy WebLinkAboutOTH Address Requests - 12/2/2004Mason County Permit Assistance Center
Address Request Form
PO Box 186, Shelton WA 98584
Genie McFarland, Addresser, (360) 427-9670 ext. 291
There is a $140.00 fee for all new addresses issued.
Please allow 5 to 10 working days for processing
Name:
Atz" (0W-) o f rl •Phone: (-4Lot 14%7,40 76 X .R
Mailing Address: ii1144 ea-tYli f I 1. IAA 5W 36a 1 & iZ
Street City State Zip
Parcel Number: 3,abO P /10/ C1 OQ i `4
Legal Description: 112 I GO()
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For official use only below this line
Your New Address Is: W A- \I
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Important: Please.place, within 60 days, your assigned address number at your
driveway location and on your structure. This will allow the most timely service in case
of emergency. In addition, please post the address with the building permit when
construction begins on the site.
Received I -2-b`i- Logged In 12:-2-64 Tidemark 0-.Q--64-1 Fire District .