HomeMy WebLinkAboutADD2019-00052 - OTH Address Requests - 3/20/2019 MASON COUNTY
RECEIVED
COMMUNITY SERVICES MAR 2 0 2019
na Buildin Planning,Environmental Health,Community Health 615 W• { 'J� r;
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Address Request Form/Application
Name: KeL,,e.1' Phone: 3G0_SS0 -$519
Mailing Address: 199S Kelo IrI& A. 5E•
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City:� �tw- State:� Zip: �� � Prefer:Mail 01;a ail notification ,,cieoncI
E-Mail Address:JICe_s IC�-I bo,-C 0.ryt
Parcel Number: " `�'`"`"�`' ?Z'�z5`�`7�/y�jy (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/W L BE LOCA ED ON THE P RCEL AND NEIGHBORING DRN AYS.
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1A .Application fee: 185 due at time of submittal The Mason County Addressing Ordinance
9' Make checks payable to:Mason County Treasurer requires you to post your new address
t3/ 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. 365 visible from the roadway or driveway.
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YOUR NEW ADDRESS IS: NF—
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RECEIVED LOGGED IN TIDEMARK FIRE DISTRICT
BILLED PAID ram, r-A/ RECEIPT#
Rev.12/27/18