HomeMy WebLinkAboutOTH Address Requests - 2/12/2007 Mason County Permit Assistance Center
�. Address Request Form
of - PO Box 186, Shelton WA 98584
Brenda ]antz, Addresser, (360) 427-9670 ext. 291
There is a $154.00 fee for a//new addresses issued
Please allow 5 to 10 working days for processing
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Name: Thomas and Barbara Reynolds Phone: 503-625-7749
Mailing Address: Po Box 362 Sherwood Or 97140
Street City State zip
Parcel Number: 321341390020
Legal Description: LOT: 2 OF SP #782 PTN TR 2 SW NE S 8/32 S 32/210
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).
For official use only below this line
Your New Address Is: 600 E Mikkelsen Rd
Shelton WA 98584
Important:Please post the address with the building permit when construction begins on the site.
Emergency services request you please place, within 60 days,your assigned address number at your driveway entrance and on your
structure.
Received 1-30-06 Logged In 2-12-07 Tidemark 2-12-07 Fire District 5
Bill