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HomeMy WebLinkAboutADD - OTH Address Requests - 12/13/2017 IVED MASON COUNTY DEC 13 2017 COMMUNITY SERVICES 615 street Building,Planning,Environmental Health,Community Health Address Request Form/Application Name:Kct1 1 ArrY-s+r+nq (A fn e s 13 kk-c) Phone: �-�� - s�7 7A VZ� Mailing Address: /O Y©S 0j ct /j'P r /R 004 City: / o LO M--, State: W# Zip:7R y6_ Prefer:Mail r e-Mail notifica ' WrckO,ui E-Mail Address: a rr,*7 Or) Fc(Y` O L . /U "r Parcel Number: 000 (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. - I�fO 1 142- Z enrk- lz!a --A1� 0 Application fee:$173.50 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 El 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 color, Addressing questions?Call(360)427-9670 ext. 284 visible from the roadway or driveway. ••rrrss+»+rrMrskwsrr*»rrwrwsrrrxwwrr�rss♦s►THIS SECTION IS FOR OFFICIAL USE ONLY� ����k *w�rrrrrr�r ss�Mswasss�rs►ws►r��rrssrw YOUR NEW ADDRESS IS: I yy E' 104- -C�5 Dry V � 6�jrZLPE'V 1E0 WA 1'8544(p RECEIVED LOGGED IN TIDEMARK FI DISTRICT BILLED PAID l RECEIPT# 53 41 --ALT - Rev.1/27/2017