HomeMy WebLinkAboutOTH Address Requests - 3/7/2010 ,W Mason County Permit Assistance Center
U Address Request Form
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PO Box 186, Shelton WA 98584 t:j
Brenda Jantz, Addresser, (360) 427-9670 ext. 291
There is a $MD-D fee for a//new addresses issued S�
Please allow 5 to 10 working days for processing
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Name: Da yp, / -Tc)n , l,eRt,� Phone: ( y ) a q
Mailing AddressP 0 ax Aw(I
Street city State Zip
Parcel Number: 07 '3��� / /
Legal Description: 4fPVW Lig6 to �& 3�r�
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).
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For official use only below this line
Your New Address Is: �1 I YlL, • -� }ULAL Lt�l A
'72u-h ,r�, LJA g85EB
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 dr�eway entrance and on your structure.
Received Logged In 3- `1 Tidemark2 7- !O Fire District
PD_ filled Case Bill
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Mason County Permit Assistance Center
Address Request Form
PO Box 186, Shelton WA 98584
HELPFUL HINTS FOR YOUR ADDRESS REQUEST FORM
Please be sure to include the following information on your form:
I. The property owner's or builder's name with the mailing address and a phone number
of someone who can answer questions in regards to the location.
2. The short legal description and parcel number for the property.
3. For directions to the site, please keep in mind that we physically have to visit the site.
Please indicate if any of the following applies to the site:
A. Name of the county road or private easement your driveway is located on.
B. Is your driveway established? If not, please show where it will be located
using stakes or flagging and clearly post your name. Special addressing
flagging can be provided upon request.
C. Does your driveway already exist and/or do you share it with a neighbor? If so
please indicate the neighbor's address.
D. Are there any landmarks such as trailers, picnic tables, or brush piles that will
help in the location of your site?
E. There is a $140.00 fee for all new address.
Please call (360) 427-9670, ext. 291 if you have any questions or require assistance in
completing the Address Request Form.