HomeMy WebLinkAboutRAP5241 - RAP Permit / Conditions - 10/25/1995 _ PERMIT
Mason County Road Department Permit Number: 5241
411 North Fifth Road Name : Little Egypt
P.O. BOX 1850 Road Number : 04670r 1�
Shelton, WA 98584 Road Location:
Subject to all terms , conditions and provisions written or printed b ow
or on any part of this form,
Permission Is Don Dumontet
Hereby Granted To: W. 4711 Dayton Airport Road
Shelton, WA 98584
426-
To Install : single family access
Location: Aprox. 650 ' from intersection with Shelton Matlock Road on the left
hand side of the road.
Parcel Number: 42017-23 -00051-
Legal Description:
A bond in the amount of $ 25 . 00 accompanies this permit .
Receipt Number: 14843 Check Number: 2168
Contractor
Address
City/St/Zip:
Phone : 426-
Lic. Number: Expires :
Specifications:
Access to be graveled to property line with 3" depth of clean gravel. Culvert to be aluminum, concrete or polyethylene.
Access will be staked and flagged by Permittee for pre-inspection. Culvert will lay in line of ditch.
Access will 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 use access shall require STOP Signs, installed in conformance to the MUTCD 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 : 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:
Title :