HomeMy WebLinkAboutOTH Address RequestsI
} Mason County Permit Assistance Center
Address Request Form
P.O. Box 578, Shelton WA 98584
Genie Mcfarland, Addresser, (360) 427-9670 ext. 291
There is a $140.00 fee for all new addresses issued.
Please allow 5 to 10 working days for processing
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Name: c1 h1 c S c /6 e Phone: (,Q 53 ) STY - �2 3 5 �
Mailing Address: 1 q 11, K, 14 . Al. d OCe- 18
Street City State Zip
Parcel Number: IQ 3 3 es / ,S- 0/ D D 6 $Z
Legal Description: 4 v e d r %Is e— �, 3
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 must be clealry marked. Please note any physical
characteristics (i.e. trailer, brush pile, picnic table).
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For official use only below this line
Your New Address Is: 3 o At L a nG, ko -/- Cry
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Important: Please 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
construction begins on the site.
Received Logged In Tidemark Fire District
Mason County Permit Assistance Center
Address Request Form L:
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P.O. Box 578, Shelton WA 98584
AW
HELPFUL HINTS FOR YOUR ADDRESS REQUEST FORM
Please be sure to include the following information on your forth
1. The property owner's or builder's name with the mailing address and a phone
number of someone who can answer questions in regards to the location.
2. The short legal description and parcel number for the property.
3. For directions to the site, please keep in mind that we physically have to visit the
site. Please indicate if any of the following applies to the site:
A. Name of the county road or private easement your driveway is located on.
B. Is your driveway established? If not, please show where it will be located
using stakes or flagging and clearly post your name. Special addressing
flagging can be provided upon request.
C. Does your driveway already exist and/or do you share it with a neighbor?
If so please indicate the neighbor's address.
D. Are there any landmarks such as trailers, picnic tables, or brush piles that
will help in the location of your site?
E. There is a $140.00 fee for all new address.
Please call (360) 427-9670, ext. 291 if you have any questions or require assistance in
completing the Address Request Form.