HomeMy WebLinkAboutADD2020 - OTH Address Requests - 12/31/2020 MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Address Request Form/Application
Name: T-'r 0 W 6 �-,k22 Phone:
Mailing Address:
City: �� 11 ; State: Zip: I'refer: ail o e-Mail notification[crr k Ole]
E-Mail Address: 'DOD
Parcel Number: I �Ll DOD (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.
•
The Mason County Addressing Ordinance
requires'you to past 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.
SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS: �n( qv\qul�
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RECEIVED LOGGED IN_� TIDEMARK'S: FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.12/27/18