HomeMy WebLinkAboutADD2019-00174 - OTH Address Requests - 9/11/2019 MASON COUNTY
COMMUNITY SERVICES
• Building,Planning,Environmental Health,Community Health
Address Request Form/Applicationo f
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Name: (le-ID14 Phone: 1.0 8�
Mailing Address: ' -Z-1 K 1_�c,Scrne
City. State: %.QN Zip: Ib�q Prefer:Mail o e-Mail notification p§releonvi
E-Mail Address: 0*ff:-,AkW1C2xC4_) Li,C-C-M
Parcel Number: (12-digit number)
SITE MAP:PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY(and most importantly a sketch).SHOW WHICH SIDE OFT E
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 ISIWILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
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0 Application fee:$185 due at time of submittal The Mason County Addressing Ordinance
0 Make checks payable to:Mason County Treasurer requires you to post your new address
0 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 reflectIV14
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 lolor,
Addressing questions?Call(360)427-9670 ext. 365
visible from the roadway or driveway,
SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS: g-7 L)ckrv�t_)o
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RECEIVED LOGGED IN TIDEMARK FIRE DISTRICT
BILLED PAID RECEIPT #
Rev.12/27/18