HomeMy WebLinkAboutADD2019-00051 - OTH Address Requests - 3/20/2019 MASON COUNTY P'tDD-�Dte1- RECEIVED
! COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
MAR 0 2019
Address Request Form/Application 615 W. A der Street
Name:_'Pj'r&R �<9,H o e,"AA R Phone:_Id to 1 -70
Mailing Address: t Z p
City-VAti �'DU"AR State:�� p Zip: Y4042 Prefer:Mat re-Ma' notificationrco-,ieo,,,I
E-Mail Address: jj��
Parcel Number: "1 Q so — U (12-digit number)
SITE MAP:PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY(and most importantly a ske ).SHOW WHICH SIDE OF THE
ROADWAY YOU WILL BE BUILDING ON IF THE ROAD INTERSECTS YOUR LAND.LIST ANY ADJACENT AD RESSES YOU ARE AWARE OF AND
NOTATE WHERE YOUR DRIVEWAY IS/WILL BE LOCATED ON THE PARCEL AND NEIGHBC ING DRIVEWAYS.
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❑ Application fee: 185 due at time of submittal Aison it u Addressing Ordinance
❑ Make checks payable to:Mason County Treasurer pcftrire$y04 to post your new address
❑ Mail application to: ----within` da s of assignment.
Mason County Permit Center It must be placed at your driveway entrance
Attn:Addressing Division clearly visible fir' the rqAd in reflective
615 W.Alder St contra 0,'ng material.
Shelton,WA 98584 Address must also , posted to any structure
within 30 days of ill!" Ction rtr a contrasting color,
Addressing questions?Call(360)427-9670 ext. 365
visible from ',road"�or driveway.
k+++x++++++»++k+++.....THIS SECTION 1S FOR OFFICIAL USE ONL'i`
YOUR NEW ADDRESS IS: CJ 1 V� L-0t0 rU S -
S 1�21 tt)n w pr
RECEIVED' LOGGED IN TIDEMAR FIRE DISTRICT
BILLED PAID-r� REC IE PT#
Rev,t2/27/18