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HomeMy WebLinkAboutUnsafe/Dangerous Structure - BLD Letters / Memos - 5/2/2016 `F, l� y S IFa9 a� Department of Labor and Industries AGENCY REQUESTED Factory Assembled Structures Program INSPECTION Complete&mail this form to the L&I FAS Program PO Box 44430,Olympia,WA.98501-4430 www.Ini.wa.fzov 6580 NE Elfendhahl Pass Rd Belfair WA 95828 Location of Investigation address --6-ty State Zip Crowell,Carol Susan 360.801.2119 Property Owners Name Telephone Number PO Box 1389 Belfair WA 98528 Property Owners Address city State Zip Mason County Community Development Tricia Woolett-Building Inspector Agency Making Request Agency Contact name tw@co.mason.wa.us 360.427.9670 ext.281 or email tw@co.mason.wa.us Agency Contact Email Agency Telephone Number 615 W Alder Street Shelton WA 98584 Agency Mailing Address City State Zip Tricia Woolett Signature and Title Date observed: May 2,2016 Describe problem observed: An inspection was performed on May 2, 2016 in order to verify whether the complaint was valid. As a result of the inspection the Mason County Building Inspector found evidence that the structure meets the definition of a dangerous building as described in the 1997 Edition, Abatement of Dangerous Buildings, Section 302. The inspector noted signs or roof failure and stated that the structure is in need of repairs. As a result,the structure is posted with DO NOT OCCUPY notice(s) at all entrances. The tenant has left the property. The structure is deemed unsafe until an inspection of the structure is completed with all necessary permits and repairs. An inspection by Labor and Industries is request to determine the extent of failure and determine if structure is safe. 1 Washington State Department of Factory Assembled Structures Labor & Industries Factory Assembled Structures Correction Report The corrections listed below are hereby ordered and must be completed within 20 days of issuance. Contractor/Owner Date of Inspection Permit Number CROWELL, SUSIE 9/15/2016 FP2740081 Address of Inspection City 16580 NE ELFENDAHL PASS NE BELFAIR NOTAPPROVED FOR COVER NOTAPPROVED FOR SERVICE Is the permit fee correct ID Yes U No Fee due$ $0.00 Correction(s)issued on: 9/15/2016 2013 HRI Other.Other(OTHER)Other obsevations Correction Issued on:9/15/2016 by West, Mark Hole found in living wall adjacent to 2nd bath tub. Hole showed mold on sheetrock, also decking in front of tub was soft. �i 2013 HRI Other.Other(OTHER)Other obsevations Correction Issued on:9/15/2016 by West, Mark Fans in both baths were not working. 2013 HRI SD.WD(WOOD SIDING)Siding(Wood)Alteration Correction Issued on: 9/15/2016 by West, Mark Wood siding installed on the manufactured home shows signs of water damage behind siding on oil four sides of home. 2013 HRI RR.COMP(COMPOSITION ROOFING)Re-roofn3 Alteration(Composition Roofing)Correction Issued on: 9/15/2016 by West, Mark Composition roofing has been installed on the manufactured home altering its original condition. No record of permit and inspection. Permit and inspection by the Department of Labor and Industries is required for this alteration. �i F201r3 HRI STR.Struc(STRUCTURAL ALTERATION)Struc`ural Trusses Correction Issued on: 9/15/2016 by West, Five(+)roof trusses have downward deflections. 2013 HRI ELC.circ(IN HOME)Electrical circuit(s)Correction Issued on:9/15/2016 by West, Mark 3 GFCI outlet not working(will not trip)in kitchen. 2013 HRI ELC.circ(IN HOME)Electrical panel box Correction Issued on: 9/15/2016 by West, Mark Panel box is in good condition. 2013 HRI Disc. (DISCLAIMER)Disclaimer Correction Issued on:9/15/2016 by West, Mark No other deficiencies were observed or apparent during the inspection; however there may be concealed issues not evident at the time of the inspection.The preceding statements are true and correct to the best of the observations, knowledge of the inspector made during the time of the inspection, in addition to the information, statements and documents provided by the individuals and representatives involved in the inspection. HRI INSPECTIONS ARE NOT SUBJECT TO AND ARE EXCLUDED FROM THE 20 DAY CORRECTION REQUIREMENT CITED IN THE HEADER OF THE DOCUMENT. Inspector West, Mark. 360 902-6710 Inspection Request Line (360)902-5242 Page 1 of 1 Q y �Y1 t889�6� STATE OF WASHINGTON DEPARTMENT OF LABOR AND INDUSTRIES INSPECTORS REPORT Subject: Agency requested Inspection Requesting Agency: Mason Co Building Department Inspection Date August 1,2016 Location: 6580 NE Elfendhahl Pass Rd,Belfair WA 95828 Manufacturer: Liberty Homes INC Serial# 09L278XU HUD#'s ORE259561 ORE259562 Department inspection report: An agency requested inspection was request and performed August 1,2016 by the Department Factory Assembled Technical Specialist Ken Knutson, and the Mason Co Building Inspection Department. This report is for building condition. All jurisdiction of occupancy is determined by Mason Co. This report is an observation only to assist Mason Co in determination of building condition. The following was observed.... Observations: Signs of failure of roof from previous leaking of roof resulting what appears to be truss failure, sign of roof sagging interior of home. Siding is damaged and looks to have rotted, cannot observe wall structure,however it appears that moisture has intruded into the wall of the home resulting in possible siding and potential failure of structure. It is the Departments observation that this building has potential for failure, resulting in agreement with Mason Co Building Department's determination that the building is unsafe for occupancy until structure is repaired and inspection approved by the Department of Labor and Industries and occupancy granted by the Authority having Jurisdiction. Ken Knutson Department of Labor and Industries Technical Specialist Tumwater Service Location E-mail knun2356_Dlni.wa.sov Phone 360-742-8272 � _ /1� - )_0JZ I MASON COUNTY , = COMMUNITY SERVICES ®r Building,Planning,Environmental Health,Community Health Notification of Mason County Code Violation 07/11/2017 Mason County Department of Community Development Shelton WA 98584 Claimant Vs. Carol Susan Crowell P.O. Box 1389 Belfair, WA. 98528 Notice The receipt of this notice shall constitute service regarding notification of violations of the Mason County Code, and shall also serve as Warning Notice pursuant to Mason County Code, Title 15, Section 15.13.035. The violation(s) are occurring at the following property- Enforcement Case No.: ENF2016-00055 Parcel No.: 22311-76-00100 Site Address: 6580 NE Elfendahl Pass Rd. Belfair, WA. 98528 On 09/15/2016 you had an inspection from the Department of Labor & Industries at 6580 N.E. Elfendahl Pass Rd. Belfair, WA. 98528. Permit # FP2740081. The inspection report contained a list of 8 corrections that require a permit from Labor & Industries. You have not purchased that permit. In order to be in compliance you must come into our office and develop a Voluntary Correction Agreement. You have 21 days from the postmark to resolve this issue. According to the Mason County Assessor records, parties named above hold legal interest in the parcel and are therefore subject to enforcement action for failure to comply. The parties shall respond to the county within twenty one days of the postmark, posting on site, or delivery of the notice. Public Health Community Development (Community Health/Environmental Health) (Permit Assistance Center/Building/Planning) 415 N.6`,Street—Shelton,WA 98584 615 W.Alder Street—Shelton,WA 98584 Shelton:360-427-9670,Ext.400 (F-1) Shelton:360-427-9670,Ext.352 Belfair:360-275-4467,Ext.400 Belfair:360-275-4467,Ext.352 Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352 Records indicate that this enforcement issue has not been resolved and is outstanding at this time. ORDER YOU ARE HEREBY ORDERED to abate violations in the following manner: Come into our office and develop a Voluntary Correction Agreement. You have 21 days from the postmark. Penalties This notice is to inform you that in the event you fail to comply, we will pursue additional enforcement action against you, including but not limited to recording against the parcel, civil infractions, liens against the property through the Mason County Hearings Examiner process and/or criminal prosecution as allowed under Title 15.13 of the Mason County Code. Note that the removal, mutilation, destruction or concealment of any Notice posted on 05/02/2016 would be deemed a separate violation of Title 14. In the event that you feel you have received this notice in error or that the facts are inaccurate, I strongly encourage you to contact me at (360) 427-9670 ext. 357 to discuss your concerns immediately. Sincerely, aw-19r1k Curt Ek Mason County Code Enforcement Officer Cc: Property File II (F-1) 2 1 Page I I COU�T� MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. 8, 615 West Alder Street, Shelton, WA 98584 www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 v, 185! CERTIFIED AND REGULAR MAIL Notification of Mason County Code Violation October 14, 2016 Carol Susan Crowell PO Box 1389 Belfair, WA 98528 Enforcement Case No.: ENF2016-00055 Parcel No.: 22311-76-00100 Site Address: 6580 NE Elfendhahl Pass Rd, Belfair WA 98528 An inspection was completed on September 15, 2016 by Mark West with Labor and Industries. At the time of inspection the following items were identified for repair or replacement. 1. Moisture inside the wall of the bathroom, with mold present. 2. The floor in the bathroom in front of the tub was identified as "soft" due to moisture. 3. Ventilation fans in bathrooms do not function. 4. Wood siding installed on home shows signs of water damage behind siding on all four sides of the home. 5. Composition roofing has been installed on the manufactured home altering its original condition. No permit of inspections. 6. Five (+) roof trusses have downward deflection. 7. GFCI outlet not working in Kitchen. These items must be repaired or replaced. An Alteration Permit is required from Labor and Industries to make these repairs. The following items must be permitted and inspected (final inspection) with Labor and Industries-, 1. A siding permit. 2. Structural permit for the new trusses and engineering for truss replacement 3. A permit to replace roof with another one due to truss replacement. 4. A structural permit for the soft decking in the bathroom around the tub. 5. A mold assessment from an independent contractor that is a mold abatement specialist. This assessment should address the mold in the wall between the bathroom and living room and regarding exterior walls. Results must verify that the mold has been abated properly. 6. An electrical permit for circuit for the fans and GFCI replacement. Question regarding these requirements you should contact Ken Knudsen at Labor and Industries at 360.742.8272 email knun235(�D_lni.wa.gov. At such time that you are close to final inspection or have had a final inspection from Labor and Industries you will need to apply for a Building Permit with Mason County-, to permit the placement of the unit. The unit was never permitted to be onsite. According to the Mason County Assessor records, parties named above hold legal interest in the parcel and are therefore subject to enforcement action for failure to comply. Order YOU ARE HEREBY ORDERED to abate the violation in the following manner: 1) DO NOT OCCUPY the structure. Immediately secure the structure and make it safe from entry. All windows, doors and other areas where entry into the structure can be made shall be secured. 2) To resolve the issues identified above, you will need a permit from Labor and Industries. Please contact Ken Knudsen, Labor and Industries Technical Specialist at the Tumwater service location. You can reach Mr. Knudsen at 360.742.8272 email knun235(aD_lni.wa.gov. 3) According to parcel records the unit on site has not been permitted or inspected for occupancy. A Building Permit and inspections from Mason County Community Development is required for occupancy of this structure this permit can not be issued or approved until Labor and Industries has permitted and inspected in accordance with L & I permit process. Or Demolish or removed the structure from the property. Call for Inspection when structure has been removed or demolished. Penalties Note that the removal, mutilation, destruction or concealment of the Notices posted on September 13, 2016, would be deemed a separate violation of Title 14. This notice is to inform you that in the event that you fail to comply, we will pursue additional enforcement action against you, including but not limited to recording against the parcel, civil infractions, liens against the property through the Mason County Hearings Examiner process and/or criminal prosecution as allowed under Title 15.13 of the Mason County Code. In accordance with MCC15.11.20, Appeals to this decision shall be filed with the Clerk of the Board within 14 days after the date of the decision. In the event that you feel you have received this notice in error or that the facts are inaccurate, I encourage you to contact me to discuss your concerns. I can be reached at (360) 427-9670 ext. 281 or via e-mail at: tw@co.mason.wa.us. Sincerely, Tricia Woolett Building Inspector Cc: Property File Barbara Adkins (Director) Enclosed: Inspection results from Labor and Industries dated 9.15.16 MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. 8, 615 West Alder Street, Shelton, WA 98584 www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 POSTED ON SITE AND REGULAR AND CERTIFIED MAIL Notification of Mason County Code Violation September 13, 2016 Carol Susan Crowell PO Box 1389 Belfair, WA 98528 Enforcement Case No.: ENF2016-00055 Parcel No.: 22311-76-00100 Site Address: 6580 NE Elfendhahl Pass Rd, Belfair WA 98528 Notice The receipt of this notice shall constitute service regarding notification of violations of the Mason County Code, and shall also serve as Warning Notice pursuant to Mason County Code, Title 15, Section 15.13.035. The violation(s) are occurring at the following property: ❑ An inspection was completed on August 1, 2016 with Mason County Building Inspector Josh Luck and Labor and Industries inspector Ken Knudsen. The report attached is Labor and Industries findings/observations. It has been determined that; "the structure has Signs of failure of roof from previous leaking of roof resulting what appears to be truss failure, sign of roof sagging interior of home. Siding is damaged and looks to have rotted, cannot observe wall structure, however it appears that moisture has intruded into the wall of the home resulting in possible siding and potential failure of structure. It is the Departments observation that this building has potential for failure, resulting in agreement with Mason Co Building Department's determination that the building is unsafe for occupancy until structure is repaired and inspection approved by the Department of Labor and Industries and occupancy granted by the Authority having Jurisdiction." According to the Mason County Assessor records, parties named above hold legal interest in the parcel and are therefore subject to enforcement action for failure to comply. Order YOU ARE HEREBY ORDERED to abate the violation in the following manner: 1) DO NOT OCCUPY the structure. Immediately secure the structure and make it safe from entry. All windows, doors and other areas where entry into the structure can be made shall be secured. Continued on next page 2) To resolve the issues identified above, you will need a permit from Labor and Industries. Please contact Ken Knudsen, Labor and Industries Technical Specialist at the Tumwater service location. You can reach Mr. Knudsen at 360.742.8272 email knun235(W_Ini.wa.gov. 3)According to parcel records the unit on site has not been permitted or inspected for occupancy. A Building Permit and inspections from Mason County Community Development is required for occupancy of this structure this permit can not be issued or approved until Labor and Industries has permitted and inspected in accordance with L & I permit process. Or Demolish or removed the structure from the property. Call for Inspection when structure has been removed or demolished. Penalties Note that the removal, mutilation, destruction or concealment of the Notices posted on September 13, 2016, would be deemed a separate violation of Title 14. This notice is to inform you that in the event that you fail to comply, we will pursue additional enforcement action against you, including but not limited to recording against the parcel, civil infractions, liens against the property through the Mason County Hearings Examiner process and/or criminal prosecution as allowed under Title 15.13 of the Mason County Code. In accordance with MCC15.11.20, Appeals to this decision shall be filed with the Clerk of the Board within 14 days after the date of the decision. In the event that you feel you have received this notice in error or that the facts are inaccurate, I encourage you to contact me to discuss your concerns. I can be reached at (360) 427-9670 ext. 281 or via e-mail at: tw@co.mason.wa.us. Si erely, Tricia Woolett Building Inspector/Josh Luck Cc: Property File Barbara Adkins (Director) Enclosed: Building Permit Application COU r MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT Mason County Bldg. 8, 615 West Alder Street, Shelton, WA 98584 =IXS-! www.co.mason.wa.us (360)427-9670 Belfair(360)275-4467 Elma (360)482-5269 POSTED ON SITE AND REGULAR AND CERTIFIED MAIL Notification of Mason County Code Violation Carol Susan Crowell PO Box 1389 Belfair, WA 98528 Enforcement Case No.- ENF2016-00055 Parcel No..- 22311-76-00100 Site Address.- 6580 NE Elfendhahl Pass Rd, Belfair WA 98528 Notice The receipt of this notice shall constitute service regarding notification of violations of the Mason County Code, and shall also serve as Warning Notice pursuant to Mason County Code, Title 15, Section 15.13.035. The violation(s) are occurring at the following property- ❑ Our office received a complaint that the structure located on the parcel identified above is a dangerous structure. An inspection was performed on May 2, 2016 in order to verify whether the complaint was valid. As a result of the inspection the Mason County Building Inspector found evidence that the structure is occupied and verified that the structure meets the definition of a dangerous building as described in the 1997 Edition, Abatement of Dangerous Buildings, Section 302. The inspection found signs or roof failure and is in dilapidated condition. As a result, the structure is posted with DO NOT OCCUPY notice(s) at all entrances. The structure is deemed unsafe. Occupancy of the structure is not approved and when occupied, would be considered a violation of Mason County code, Section 14.12.050. According to the Mason County Assessor records, parties named above hold legal interest in the parcel and are therefore subject to enforcement action for failure to comply. The parties shall respond to this county within twenty days of the postmark. Order YOU ARE HEREBY ORDERED to abate the violation in the following manner- 1) DO NOT OCCUPY the structure. Immediately secure the structure and make it safe from entry. All windows, doors and other areas where entry into the structure can be made shall be secured. Once the structure is vacant and secure from entry, contact our office, no later than twenty (20) days of the postmark of this notice, to arrange for a site inspection to verify compliance. During the inspection the inspector can also discuss compliance options. 2) To resolve the issues identified above, you will need to have an inspection from Labor and Industries for Fire and Life Safety. In addition you may be required to get a permit from Labor and Industries to repair the structure to be it up to codes and standards. See attached document/application. According to records on file the unit on site have not been permited or inspected for occupancy when placed on the parcel. A Building Permit and inspections are required for occupancy of this structure. Or Demolish or removed the structure from the property. Call for Inspection when structure has been removed or demolished. Penalties Note that the removal, mutilation, destruction or concealment of the Notices posted on May 6, 2016 would be deemed a separate violation of Title 14. This notice is to inform you that in the event that you fail to comply, we will pursue additional enforcement action against you, including but not limited to recording against the parcel, civil infractions, liens against the property through the Mason County Hearings Examiner process and/or criminal prosecution as allowed under Title 15.13 of the Mason County Code. In accordance with MCC15.11.20, Appeals to this decision shall be filed with the Clerk of the Board within 14 days after the date of the decision. In the event that you feel you have received this notice in error or that the facts are inaccurate, I encourage you to contact me to discuss your concerns. I can be reached at (360) 427-9670 ext. 281 or via e-mail at: tw@co.mason.wa.us. 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For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Da of elivery or on the front if space permits. L •�. cl�O LO LL (� g 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑ No � 'Pls �ax l� it I�III'I I'll I'I i l i I I l ll III I�III I l I III I ll I I I 3. Service Type ❑Priority Mail Express ❑Adult Signature El Registered MaiIT^' 1-1 AdultSignature Restricted Delivery El Registered Mail Restricted 9590 9403 0713 5196 3972 80 Certified Mails Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for T ❑Collect on Delivery Merchandise .. . .• ._ _ __ ____�_-�..,,.,.,„,.„,;,.„r„ti„n ❑Collect on Delivery Restricted Delivery O Signature Confirmation— Insured Mail El Signature Confirmation 7008 1300 0001 6923 5256 Insured Mail Restricted Delivery Restricted Delivery -- _..(over$500) PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+41" in this box* f LIVYY)YY)ULXA 1_t_L 01 Lo _'S.Off v 15 USPS TRACKING4 JJ:ji Postal CERTIFIED MAIL,r., RECEIPT (Domestic Mail Only; .• Provided) fU For delivery information visit our website at www.usps.com;, U-1 myy <: •, nLI Postage $ Certified Fee 17-1 Return Receipt Fee c �r i3 (Endorsement Required) ` Restricted Delivery Fee (Endorsement Required) O � m Total Postage&Fees r-q o L s (1._----�___'-- or ........�------- p Street,Apt.No.; 1 or POBoxNo.-��---l 1--r'-'---,-- --------.....------------- City,State,ZIP 4 � PS Form :00 August 2006 See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. ■ Certified Mail is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. SignIture ■ Print your name and address on the reverse .X ❑Agent so that we can return the card to you. �-Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name C. Date of D@livery or on the front if space permits. C� c �- 1. Article Addressed to: D. Is delivery ad n Jr_ es !�L tj . ��Vl / , o W 0-1 I If YES,enter li s slow: o T v 13o x ` SEP 2 2 2�i6 P-.0 + r �� gbG2a 615 W. Bider Street II I'lllll I'II I'I I I I I I II III I'III I I II I I I'II I III 3. 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FICIAL '• s� a PS Form 3800.August 2006 See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt _ a ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery`. ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000.9047 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A._Signature item 4 if Restricted Delivery is desired. X ���� ❑Agent ■ Print your name and address on the reverse JR Addressee so that we can return the card to you. B. Received by(Printed Name) C. pate of Delivery ■ Attach this card to the back of the mailpiece, e� S �..��G 15116 or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? Yes If YES,enter delivery address below: ❑No I lCP aoL `)LAS a'O G(01W WD 3. Service Type Certified Mail® ❑ Priority Mail Express`" Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7008 1300 0001 6923 5805 (Transfer from service label i PS Form 3811,July 2013 Domestic Return Receipt I UNITED STATES-.'}f61a?-4ERVICE First-Class Mail Postage&Fees Paid • USPS - w:.:6K5•.i5:`' '"+ Permit No.G-10 • Sender: Please print your name, address, and ZIP+40 in this box* I � I � Mason County Community Services DeparbyWd_ 615 W.Alder Street RECEIVED Sheftw,WA 9MU MAY 19 2016 I I 615 W. Alder Street I I � : ibit ill"►Iliii'I�'IIliii�ilj►ii'I"I!'I'I"i"'I'lillllliilii�j���ii � I