HomeMy WebLinkAboutRAP6157 - RAP Permit / Conditions - 9/10/1996 a PERMIT
Mason County Road Department Permit Number:
411 North Fifth Road Name : 1579
n
P.O. BOX 1850 Road Number :
Shelton, WA 98584 Road Location: W( O d
Subject to all terms, conditions and provisions written or printed below
or on any part of this; /form,
Permission Is
Hereby Granted To:
To Install : ;Z-U a I
Location: - �S
Parcel Number: 2?27 -30 — S( — OOU 58
Legal Description: �Szc u� �
A bond in the amount of
$ accompanies this permit.
Receipt Number: Check Number:
Contractor :
Address 5.p /✓,F, �a n-c 7
City/St/Zip: )3Le � t V01- 9 93 zSr'
Phone
Lic. Number: 27S—S2� L� Expires:
Specifications:
Access to be graveled to property line with 3" depth of dean gravel. Culvert to be aluminum, concrete or p Dlyethyiene.
Access wit be staked and flagged by Parmittee for pre-inspection. Culvert wit lay in line of ditch.
Access wit be pre-inspected by this office prior to installation. Culvert to be minimum of 12" diameter by 20' length.
Access installation shall be in accordance with county specifications.
Commercial/Multi we access shall require STOP Signs, installed in conformance to the MUTCD manual,at intersectior with county road.
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 Washington, this day of 19 C.
Issued by:
Title :
MASON COUNTY ROAD DEPARTMENT
Courthouse Road No.: O
Shelton,Waddroon
PERMIT Road Nase: �
Subject to all terms, conditions and provisions itten or printed below or on pny part of this form,
PERMISSION IS HEREBY GRANTED TO
Address Al r &jam?0 2
To install �,a' onto County
Road No. I/ •
L,,pap�ion.
' v
1
e
Legal Description: S� C
E REMARKS• O �
13-77
IF CULVERT IS NECESSARY: Culvert to be seta], concrete or Polyethylene.
Culvert to be sisisus of 12' diaseter by 20' is length.
(f25.00 bond required.) Culvert will lay is liae of ditch.
Access to be graveled to property lise with 3' of clean
gravel.
00
A Bond in the asount of f�0 accospaaies this perst.
(Rct. i�:Z6 ; Check ! t"'A.L .)
Cantractcr: Address:
Phone: Lic. No: Exp.:
Access will be staked at,d flagged by Feraittee for preinspection.
Access will to rreinspectcd by this office prior to installation.
Installation shall be in accorda►.•ce with county specificatioss.
No work shall be done under this permit until the party or parties to whom it is
granted shall have communicated with and received instructions from Road Supervisor,
Phone: 427-9670; Ext'n: Z-2Q -
This permit shall be void unless the-work herein contemplated shall have O2� p t been completed before.
Dated at Shelton, Wash., this day of ��•—(f 19
Issued by: Z�
Title:
i