HomeMy WebLinkAboutADD2020-00254 - OTH Address Requests - 10/19/2020 b -
MAsoN COUNTY RECEIVED
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health O r t n ^O^n
Address Request Form/Applicatiox>I„
c�15 W.. Alder StreetName: 1 p1U t BUST ct ► Phone: (360) •,•2` `162S
Mailing Address: P. 0, Buy
City: S if �f 1L� �{ ] State: W Zip: i ` Prefer:Mail or -Mail notification Cirde One
E-Mail Address: IdC�? agG�el2n� CDm
Parcel Number: I�P-Z l —50 W-2z (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.
covocortb goc4- Arnrj r(oA)'j �orZ OF SI7 3016
II
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 3030 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:%rt a contrasting solo ,
Addressing questions?Call(360)427-9670 ext. 365 visible from the,roadway or driveway.
*******************************************THIS SECTION IS FOR OFFICIAL USE ONLY************************************************
YOUR NEW ADDRESS IS: U (CA I -P; Lev- l rc
RECEIVED t! LOGGED IN [i TIDEMARK ] FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.12/27/18