HomeMy WebLinkAboutRAP9660 - RAP Permit / Conditions - 3/6/2005 PERMIT D
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Mason Countyy Road Department Permit Number:
411 North Fifth Road Name P.O. Box 1850 Road Number
Shelton, WA 98584 Road Locationi >C�,C;�
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is (� X �
Hereby Granted To: �J1-� ���� C5J/V
To Install: Roo q 6,C Pej
Location:
Parcel Number: `7 O 0 / O
Legal Description:
A bond in the amount of $ accompanies this permit. d
Receipt Number: Check Number:
Contractor : &gd w, ! Sd
Address
City/St/Zip: Kk),Du� 4 5 2
Phone : 3C-c,)-- l - -9 7
Lie. Number: C ( O 3 Expires: 3 C (�
Specifications:
Access to be graveled to property line with 3"depth of dean gravel. Culvert to be aluminum,concrete or polyethylene.
Access will be staked and flagged by Permittee for pre-inspection. Culvert will lay In faro of ditch.
Access will be pr*-inspected by this office prior to installation. Culvert to be minimum of 12"diameter by 30'length.
Access installation shad be in accordance with county specifications.
CommercialIMUld use access shall require STOP Signs,installed in conformance to the MUTCO manual,at intersection 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: 360-427-9670 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:
Dated at Shelton, Washington, this day of ,
Issued by:
Title: