HomeMy WebLinkAboutRAP9129 - RAP Permit / Conditions - 1/7/2000 J A N 07 2000 PERMIT o
Mason Coun d0t�b�lldMW0WS Perini t Number:
411 North Fi h Road Name : � -
P.O. Box 185 Road Number :
Shelton, WA 98584 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is SJWS00 TkWID, CO,
Hereby Granted To:
P.o. �ox 96o
SjiEL7.Dp , WR Q 9S8y WT. FRCO WCD441
To Install: 1TC47OR& 40-CEYS wly C04var IAX sew
Location: - Amu. STA. LiSt75 mRSou LAKE k6k0) W L•'ST- S 1D(' C,o . ROArO,
�t TrmP. 1.0.C.11JG gpUR IS MARY,0 wlT4 Fl-L)O se�,uf P/uk JQ1Bl36�(1� R�cJ
/69- aLoe- PllNT.
Parcel Number: ;t
Legal Description:
A bond in the amount of $ accompanies this permit.
Receipt Number: Check Number:
Contractor
Address
City/St/Zips
Phone
Lie. Number: Expires:
�pegifications:
AooMs to be grsvoW to property Ib»with s'depth of clean or". Cdvart to be alu km m.concrete w polyednylend.
Access wi be Staked and flagged by Permitted for pre-inspeetbn. Cdwrt wi lay in One of dilch.
Aoodas wi be pre4napected by this office prior to bnstooation. Cdnnrt to be minimum of 12'diameter by 20'length.
Access instaOation shd be in accordance with county spocftadons.
C.O mmarcwmul i we aeeeae SW mgt*e STOP Signs.installed in conformance to to MUTCO maned.at intersection with county mad.
No work shall be done under this permit until the party to whom it is
granted has communicated with and received instructions from the road
supervisor at: 427-9670 ext. 450 or at 1-800-562-5628 ext. 450.
RESULTS OF SITE INSPECTION: See Attachment "A"
This permit shall be void and bond forfeited to Mason County unless the
work herein contemplated shall have been completed on or before:
19
Dated at Shelton, Washington, this day of 19
Issued by:
f
Title: