HomeMy WebLinkAboutOTH Address Requests - 4/25/2024 MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Address Request Form/Application
Name: L y d\j N E /9 1\) 1D 7t 1>L � I S o Phone:
Mailing Address:
City: State:i-l0 Zip: �e 4 Prefer:Mail or e-Mail notification tarckone]
E-Mail Address: r S4 I n s I a nd 611 r 41 ' i J
Parcel Number: 7 601. (12-digit number)
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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.
❑ Application fee: $173.50 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 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.
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RECEIVED LOGGED IN TIDEMARK/ FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.1/27/2017