HomeMy WebLinkAboutOTH Address Requests - 5/4/2001 Mason County Permit Assistance Center 0
' Address Request Form
P.O. Box 578, Shelton, WA 98584
Genie McFarland,--M---aresser, (360)427-9670, ext. 291
There is $15.00 fde for all new addresses issued.
Please � +o 10 workinq days for rocessin
Name: ��ini�i t� IC1 ►vl'rarp���
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Parcel Number: 14a DDE� l L° I
Legal Description: 121 OF"� 1P
Please draw a diagram of your property including the nearest existing county or
private road and nearest existing address. Keep in mind that we physically visit
most sites. Your proposed driveway must be clearly marked. Please note any
h sical characteristics i.e. trailer, brush pile, picnic table.
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FOR OFFICIAL USE ONLY BELOW THIS LINE
Your New Address Is:
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Important: Please place, within 60 days, your assigned address number at your
driveway location and on your structure. This will allow the most timely service in
case of emergency. In addition, please post the address with the building permit
when construction begins on the site.
Received f4-0 Logged I - 10-61 Tidemark I V-01 Fire district
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