HomeMy WebLinkAboutOTH Address Requests - 1/31/2012 ******* 173.50 FEE WILL BE APPLIED *******
50N CO
�P DEPARTMENT OF COMMUNITY DEVELOPMENT
ADDRESSING DIVISION
Addressing Technician
_ PO Box 186, Shelton WA 98584
1 8 s A (360) 427-9670 ext.
NAME: 1'r {1 PHONE�- Q- CQO
MAILING ADDRESS: �� JE- &UL: . , (_/LQ�y CITY STATE (kJ A ZIPia5
PARCEL NUMBER: 12-22-n -50- LC -1006 E-MAIL ADDRESS
LEGAL DESCRIPTION: >4 1 &
PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY.WHICH SIDE OF THE ROADWAY YOU WILL BE BUILDING ON IF THE
ROAD INTERSECTS YOUR LAND.ANY ADJACENT ADDRESS YOU ARE AWARE OF AND SIMPLE DIAGRAM OF WHERE YOUR
DRIVEWAY WILL BE LOCATED ON THE PARCEL.PLEASE LET USKNOWIFACCESSIS IMPEDED BYA GATE!
KEEP W"
YOUR PROPERTY
RECORDS
The Mason County Addressing Ordinance requires you to post your new
address within 30 days of it being issued to you.
It must be placed at your driveway entrance clearly visible from the road in reflective contrasting material.It must be posted to
any structure with 30 days of its erection in a contrasting color,visible from the roadway or driveway.
*r**rxw*rrrswasrr»rsrwrw**rwaws*rr*rrrr»rtrrw+TlllS SECTION IS FOR OFFICIAL USE ONLYr*sr*rrr*rresr*rr*wsr*sr*M»r*twasrrrrk*srrwrs:saraa
YOUR NEW ADDRESS IS: _
o�
RECEIVED orb LOGGED IN 3 as I TIDEMARK I 31 ,;01A FIRE DISTRICT` _
BILLED CASE PAID RECPT #