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HomeMy WebLinkAboutRAP9035 - RAP Permit / Conditions - 5/10/1999 PERART ad Pd MasoNn Coun Road Department permit X mber:Box 1 h �d er 1 o *10 Shelton, W 8584 Road Location Subject to all ter: ls conditions and provisions written or printed below or on any part of th�.s form, Permission In �,Q 8a l�u��� Hereby Granted To: '31ELFAIR. G V,.JJ1r4e. , L L G 0-6 17 �W W�IK0 r1 Ur,Je (31a(�'A (P- 3 77 \To Ynstal l: SZoo tj l4ff PWA t-M W-Q Aft&jeo PlAgS t 4 j*RD`n.000 Z Location: - 5ou-rH Stof of 1eay t3oAfl V.041) I woI 404r oovG4i0IDN 44WE Parcel. Number: Legal Description: PARGI:t= 3.1 f3LA 9848, /1f j` 671493 A bond in the amount of $ accompanies this permit. Receipt Number: Check Number: Contractor : (> J_ ?AV I s44 GO. 4Cnc, Address : Y.O. T3" A520 City/St/Zip: tw� on�t 1 Link gt312 . Phone = 3*0 4'A-4too Lie. Number: p,GR QA 27SK•S Expires: S/S/`9 i Specifications: Aoo to be pratrdad to pr""I m whh i-dptb of abm WnW. Cdvm to be 4umbm%aonaata or polyathylana. Aawa vA be sukW and ikSW by p enrit:aa for pr**wpwftn. C~wR ky In Iina of ditch. ? Aeoa %vN be prainspaao.d by thin oflioa prior to b vA*dan. C~to bo mk imm of 12-diomew by 20'lanpth. AonM inaukdon shell be in a000r"m wNh powly apaapioado . — Comma*WffAuW—noowa thol npuln STOP slorw.hw"W In aenfornm m ao Vn MUTCD ma mL at bawasadon with county road. i No work shall be done under this permit until the arty to whom it is granted has communicated with and received instructions from the road supervisor at: 360-427-9670 ext. 450. RESULTS OF- SITE INSPECTION: Sea Attaobment "A" This permit shall be void and bond forfeited to Mason County unless the work herein contemplated shall have been completed on or before: Dated at Shelton, Washington, this day of , Issued by-. Title: