HomeMy WebLinkAboutOTH Address Requests - 12/26/2017 MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Address Request Form/Application
Name: Phone: d,�5— 776 - Jr- to;?-142
Mailing Address: aU e- J, r
City: W I State: A Zip: 9 60 la Prefer:Mail or e-Mail notification tGr.L.ones
E-Mail Address: h v'm , C,O
Parcel Number: �I e-L6 V l I v 1`1 L t (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 ING ON ERSECTS YOUR LAND. LIST ANY ADJACENT ADDRESSES YOU ARE AWARE OF AND
0 ATE WHER DRIVEWAY IS/WI BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
I A a 18 - 52 - 0000(a
RECEIVED
DEC 2 6 2017
615 W. Alder Street
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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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