HomeMy WebLinkAboutADD2019-00174 - OTH Address Requests - 9/11/2019 MASON COUNTY
• COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
as
Address Reguestform/Application
Name: Dq �tLA'A V__1 Phone: C'
Mailing Address: k E C_VL.�< p_17>
City: State: WN Zip: 9 7 55_SSL1 Prefer:Mailo e-Mail notification t releo,,.j
E-Mail Address: i-i Ve_C_C-01
Parcel Number:320 1 QQ 1?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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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 entranc
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 lor,
visible from the roadway or driveway.
zzzwzzzzzzzzzzwwzzwwzzzzwzwzzzzzwzzzzzzzzzzTFIIS SECTION IS FOR OFFICIAL USE
YOUR NEW ADDRESS IS: 8 7 0 F 'Do-ni e-As
RECEIVED LOGGED IN TIDEMARK FIRE DISTRICT
BILLED PAID— RECEIPT #
Rev.12/27/18