HomeMy WebLinkAboutADD2022-00177 for BLD2022-00885 - OTH Address Requests - 8/30/2022 -b6J
MASON COUNTY
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Address Request Form/Application
Name: Phone: 12AC4 — oZ�
Mailin Address: M 4 6 b -AVE S ()n L,- 1' U
City: State: AJA Zip: Prefer:Mail or a-Mail notification rc;rdeone7
E-Mail Address: _ - 1 3'n
Parcel Number: (12-digit number)
SITE MAP:PLEASE PROM 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 ISIWILL BE LOCATED ON THE PARCEL AND NEIGHBORING DRIVEWAYS.
❑ 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 3030 days of assignment.
d t d l t b It muse pace a your driveway entrance
Mason County Permit Center �I
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.
.. ...•»•.......».».• ..•••*».,s•tr r» .** *THIS SECTION IS FOR OFFICIAL USE ONLYr•:rr••nrt•r•r•••r tsarr t +sswtrw•s•••r ••r»w •
YOUR NEW ADDRESS IS: lI to
- P W
c
RECEIVED❑ LOGGED IN❑ TIDEMARK 0 FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.12/27/18 F&2, 5 1,d o'2O;t A• W