HomeMy WebLinkAboutOTH Address Requests - 8/13/2008 MASON COUNTY
COMMUNITY SERVICES RECEIVED
Building,Planning,Environmental Health,Community Health AM 13 2018
Address Request Form/Applicat 615 W. Alder Street
Name: rarl��� ameS NC)f o Phone: �yD AD
Mailing Address: 'Pr 0 X ZG S
City: Sh 2 I I C)n State:WL Zi cLS 5S_Q_ Prefer:Mail or e-Mail notification ici.ae onej
E-Mail Address: EEGl✓1 U c)n Ill U 4 e Q 1 �.�Qi Y Cnim
Parcel Number. _ _ (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.
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❑ Application fee: $173.50 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. 284 visible from the roadway or driveway.
.......M. .....**THIS SECTION IS FOR OFFICIAL USE ONLY",,.»**-x..,
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Sh&uvlL._. Ci 65844
RECEIVED 2 i IDEMARK E FIRE DISTRICT
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BILLED PAID RECEIPT
Rev.1/27/2017