HomeMy WebLinkAboutOTH Address Requests - 9/12/2012 ******* 173.50 FEE WILL BE APPLIED *******
�PSON CO'D
DEPARTMENT OF COMMUNITY DEVELOPMENT
ADDRESSING DIVISION
Addressing Technician
PO Box 186, Shelton WA 98584
s s a (360) 427-9670 ext.
NAME:
PHONE:`3 0 -3 � I�17
MAILING ADDRESS: 3 1 0��p L e. Qy� CITY CLt�(`c� .STATE tip' ZIP Gl
PARCEL NUMBER: 12- C-L2CU20 E-MAIL ADDRESS u i kt(4 -' .sc4 r0C hff--a C cm
LEGAL DESCRIPTION:
PLEASE PROVIDE DRIVING DIRECTIONS TO THE PROPERTY.WHICH SIDE OF THE ROADWAY YOU WILL BE BUILDING ON IF THE
ROAD INTERSECTS YOUR LAND.ANY ADJACENT ADDRESS YOU ARE AWARE OF AND SIMPLE DIAGRAM OF WHERE YOUR
DRIVEWAY WILL BE LOCATED ON THE PARCEL.PLEASE LET US KNOWIFACCESSISIMPEDED BYA GATE!
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RE'C' D e v�%�N w
2012 KRVIVO
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The Mason County Addressing Ordinance requires you to post your new
address within 30 days of it being issued to you.
It must be placed at your driveway entrance clearly visible from the road in reflective contrasting material.It must be posted to
any structure with 30 days of its erection in a contrasting color,visible from the roadway or driveway.
+++rrr+r+rrrrrrrrr+rr++++++rrrrrrrr+rrrr++rrr"THIS SECTION I$FOR OFFICIAL USE ONLY"r+rrrrrrrr+rrrrrrrrr+++r+r+++++rrrrr+rrrrr+rrrrr+r
YOUR NEW ADDRESS IS:
RECEIVED I LOGGED IN - � TIDE f FIRE DISTRICT
BILLED CASE PAID RECPT #