HomeMy WebLinkAboutADD2021-00026 - OTH Address Requests - 1/22/2021 1 l.1
MASON RECEIVED
COUNTY RE
COMMUNITY SERVICES JAN 7 2 2021
Building,Planning,Environmental Health,Community Health
49 615 W, Alder Street
Address Request Form/Application
Name: TIN EL 4'_k'Ae t L Phone: Dix
Mailing Address: 10a Z,3 A,:L , SRN' � w
City: `'.;1 PkLV P State:W E} Zip: Qa31 I Prefer:Mail or a-Mail notification tcitaeoei
E-Mail Address: o'<k�e\\ �i�S 3
Parcel Number: W 7 7A I y- 9 ^ 9 0 IS-2 (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 AND
NOTATE WHERE YOUR DRIVEWAY IS/WILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
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Application fee: 185 due at time of submittal The Mason County Addressing Ordinance
Make checks payable to:Mason County Treasurer requires you to post your new address
Mail application to: within 30 das 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
Addressing questions?Call(360)427-9670 ext. 365
within 30 days of its erection in a contrasting c lor,
visible from the roadway or driveway.
**'*******TMS SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS:
RECEIVED LOGGED IN � TIDEMARK❑ FIRE DISTRICT
BILLED_—_____ PAID________ RECEIPT #
Rev.12/27/18