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HomeMy WebLinkAboutADD2021-00069 - OTH Address Requests - 3/4/2021 �oa©-7 MASON COUP f " • COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health �� 0 4 2021 Address Request Form/AVVlij3� W. Alder Street Name: aan Sit ,. 0 t Phon - Mailing �A—ddress: r City:�,Sc T c�a�,,l � State: wi r Zi 3 P::y£ Prefer:Mail r e-Mail notification i .,ieOne] E-Mail Address: r -�.� Q S Parcel Number: 5(3C C) (12-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 AN NOTATE WHERE YOUR DRIVEWAY IS/WILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS. d OFF � M(,sate �.c"� (2 / /,) ���r GGje co� e J 0-/'Application fee: 185 due at time of submittal * [a/Make checks payable to:Mason County Treasurer re�glx� 1 { � ❑,"Mail application to: r " xt+ Mason Count Permit Center � � � , Y ?� y �ci»i�r�r Attn: Addressing Division +`leaiysib 615 W. Alder St t Shelton, WA 98584 �� . e��tii�s�tt �lre Addressing questions?Call(360)427-9670 ext. 365 � SECTION IS FOR OFFICIAL USE ONLY YOUR NEW ADDRESS IS: e15�� �I,C'a(, .� l RECEIVED a LOGGED IN TIDEMARK FIRE DISTRICT BILLED PAID RECEIPT# Rev.12/27/18