HomeMy WebLinkAbout09900 - RAP Permit / Conditions Road No: 09900
Road Name: Dayton Airport
MASON COUNTY ROAD DEPARTMENT
411 North Fifth
Shelton, WA 98584
PERMIT
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: Donald Dumontet
W' •S 4
Address: 4412 West Dayton Airport, Shelton, WA 98584 Phone: 782-5464
To convert a single family access to a commercial access.
Location: Directly across from the fire station. (A); tj L�e
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Legal Description: RP 42017 22 00070 - West 200' of NW NW S of R.R EX
REMARKS:
Culvert Specifications: Culvert to be metal, concrete or of hyl
Culvert to be minimum of ;; ter by e rA.
Culvert wiU lay in tth. ye,,V
Access to be ! e to,pr;pe Ik�with 3" of clean gravel.
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A Bond in the amount of 0 accompanies this permit.
(Rct. # 12851 heck # 1286 .)
Contractor: Address: Phone:
License No: Expires:
* Access will be staked and flagged by Permittee for pre-inspection.
* Access will be pre-inspected by this office prior to installation.
* Access installation shall be in accordance with county specifications.
* Commercial/multi use access shall require STOP sign, installed in
conformance to the MUTCD manual, at intersection with county road.
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 the
Road Supervisor , Phone: 427-9670 extension 450.
This permit shall be void unless the work herein contemplated shall have been
completed on or before 19
DATED at Shelton, Washington, this day of 19
Issued by:
Title: