HomeMy WebLinkAboutADD2021-00218 - OTH Address Requests - 7/13/2021 OeD
MASON COUNTY JUL 13 2021
COMMUNITY SERVICES 615 W. Alder Stree it
Building,Planning,Environmental Health Community Health
Address Request Form/Application
Name: �� L K Phone: Z D - � _Z2 S
Mailing Address: F7,03 1/)s a"eir_
city: ' e P'# S te:� Zip: D Prefer:Mail ore Mail notification tad,
E-Mail Address: St7Uo'Lot C.O!r1$��/'R i h G 10 !A I Qi
Parcel Number. 2. 202111320162 Z L/ (22-digit number)
SITE MAP:PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY(and most importantly a sketch).SHOW WHICH SIDE OF THE
ROADWAY YOU WILL BE BUILDING ON IF THE ROAD INTERSECTS YOUR LAND.LIST ANY ADJACENT ADDRESSES YOU ARE AWARE OF AND
NOTATE WHERE YOUR DRIVEWAY IS/WILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
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1�_ 0;� cist- 1�L°�t� ��Du R� �
R-NOAA- on f�st Road
Pro f, ` 00 - kfr, r �Y* 5t� bd I
;( Application fee: 185 due at time of submittal The Mason County Addressing Ordinance
Rl Make checks payable to:Mason County Treasurer requires you to post your new address
Mail application to: within 30 days of assignment.
Mason County Permit Center It must be placed at your driveway entrance
Attn:Addressing Division clearly visible from the road in reflective
615 W.Alder St contrasting material.
Shelton,WA 98584 Address must also be posted to any structure
within 30 days of its erection in a contrasting colo
Addressing questions?Call(360)427-9670 ext. 365 visible from the roadway or driveway.
•rr»sr**nsrra:r+r»rrMrswsss*r+ rxas*ssrr»sr*THIS SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS: Dow i n ,s Rj
-RECEIVED is LOGGED IN,-.! TIDEMARK F FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.12/27/18