HomeMy WebLinkAboutADD2019-00050 - OTH Address Requests - 3/20/2019 ..QP 2-0P- 000c--a
MASON COUNTY RECEIVE
COMMUNITY SERVICES MAR 2 0 2019
Building,Planning,Environmental Health,Community Health
615 W. Al&,x S tr ;
Address Request Form/Application
Name: f"�I C� l Ce- Phone: 9f2 Z7 t2 7
Mailing Address:- ��(�S T S �� 30 2L
City:'! T k� (f� State: VIA Zip:- Prefer: i.
Mail or e-Mail notification for o e
E-Mail Address: Ic aAA Ceu `�� d /
L0 ( , c 0 M
as p Parcel Number: " -1 ^ 000ff D (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 BE BUILDING ON IF THE ROAD INTERSECTS YOUR LAND, LIST ANY ADJACENT ADDRESSES YOU ARE AWARE OF AND
NOTATE WHERE YOUR DRIVEWAY IS/WILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
1�VI) Mef-z r- 001
❑ Application fee: 185 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. 365 visible from the roadway or driveway.
"»•• '*'•*"*•'•**••*"'"***"*****""»•••••••THIS SECTION IS FOR OFFICIAL USE ONLY»» ... •...» . . •....� �.� ..».. •....... .r»•
YOUR NEW ADDRESS IS: H'C H �— E= SPZ --,;0 �2—.
RECEIVED❑ LOGGED IN❑ TIDEMARK❑ FIRE DISTRICT C7
BILLED PAID RECEIPT#
Rev.12/27/18