HomeMy WebLinkAboutADD - OTH Address Requests - 3/21/2005 Mason County Permit Assistance Center
address i"uest Form . T .
P0. 039 i86, $hallft WA.98W4
Genie McFarland, .A&kwscr, (560)A..V-9670 ext. 291
There is a $140.00 fee for all new a"t"ser issued.
Please allow 5'to 10 worldnq* days for proo nkV
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Moiling Address: . .
Street U City S ,' VZip:
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Parcel tqurnber: ., 06 /a
426 W. CELIAR STp
al description: I
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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 trust.be'clealry marked. Please note_any physical
characteristics. i.e. trailer, brush 'le, icni'c table .
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For official use only below this One
Your New Address Is:
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important: P1ease.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
cotlstruction begins on the site.
Pl�njyed,3� Logged/In 3-Z I -0 5 Tidemark 3 Z►-0 5 Fire District
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