HomeMy WebLinkAboutADD2022-00181 Lot 140 - OTH Address Requests - 8/23/2022 MASON COUNTY
•' COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health
Address Request Form/Application
Name: n Wl' 1 1�.l� 1►i1►C� Phone: sa 53 •— cl Y - 1-3
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Mailing Address: 33 y 5-5 Lc7F -,AveVQQ-�'��,,��- B
City ( CAL Ujet," State. LJA Zip: C�3 Prefer:Mail or a-Mail notification[ci,&ow
E-Mail Address: 1 Y l v1&y— a
Parcel Number: l An a 140 (12-digit number)
SITE•MAP:PLEASE PRONTO RMNG 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.
❑ Application fee: 185 due at time of submittal %;_-::The Mason County?,ddrassing Ordinance:'j':
❑ Make checks payable to:Mason County Treasurer -, "=, `.?eq p.yq to post yotir new.address-.-- `.:
❑ Mail application to '3U da. ii o-b `assignmgnt
Mason County Permit Center i`.: It._ ? t:be placed:at your driveway entrance,
Attn:Addressing Division _` :';'Plearly_visible_from the road in refle-div`e"°.. '
615 W.Alder St `'' =lconixasiiig,aiateriaL:'..=
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Shelton,WA 98584 { Address niiastalso lie posted to any structure';
!within 30 days'of:its erection.in a contrasting solo%�
Addressing questions?Call(360)427-9670 ext. 365 ::::•r:=vis%bl '-ft— he-ioadviiay or'driveway.-_
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YOUR NEW ADDRESS IS:
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RECEIVED 0 LOGGED IN❑ TIDEMARK❑ FIRE DISTRICT
BILLED PAID RECEIPT#
Rev.12/27118 "g f