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HomeMy WebLinkAboutAccess Connection M93-021 - RAP Permit / Conditions - 3/22/1994 Washington State District 3 Headquarters Department of Transportation 5720 Capitol Boulevard,Tumwater P.O.Box 47440 Sid Morrison Olympia,WA 98504-7440 Secretary of Transportation March 22 1994 (206)357-2600 ° d Fax(206)357-2601 North Mason United Methodist Church P.O. Box 1197 Belfair, WA 98528 Attention: Robert Helm Phone (206) 698-9140 SR 3 C.S. 2305 Completion Date Extension Access Connection Permit M93-021 Mile Post 27.71 Right E.C. File #92602 - M Dear Mr. Helm: The completion date of your executed general permit M93-021 allowing you to perform work within the state highway right-of-way, has been extended from March 31, 1994 to March 31, 1995. Make this revision to your Access Connection permit and keep this letter with the original documents. Your "Assignment of Escrow" will need to remain in place at "Olympia Federal Savings" in Belfair, WA. during the extended period. Before beginning work on this project please contact both the Area Maintenance Superintendent and the Utility Underground Locate Center to advise them of your planned work, starting date, and location. The Area Maintenance Superintendent's phone number is on the front page of the Special Provisions, and the Utility Underground Locate Center phone number is 1-800-424-5555. No work is authorized within the state highway right-of-way until this notice is given. Upon completion of work on this approach please make written request for inspection and release of escrow, as provided under Special Provision No. 22, to the Area Maintenance Superintendent. It is your responsibility to provide any release of escrow forms required by "Olympia Federal Savings". Please call Ted Samland at (206)-357-2667 if you have further questions regarding this permit. Sincerely, C, c DAVID B. HILDERBRANT, P.E. Assistant Transportation Planning Engineer DBH TLS cc!a- `Mason County cc: M. McGill k-13 -, Washington State District 3 Headquarters TAP Departmentof Transportation 5720 Capitol Boulevard,Tumwater P.O.Box 47440 Duane Berentson Olympia,WA 98504-7440 Secretary of Transportation January 26, 1994 (206)357-2600 North Mason United Methodist Church Fax(206)357-2601 P.O. Box1197 � t � r Belfair, WA 98528 'As JAN 3 1 1994 Attention Robert Helm MASON Co Phone: (206) 698-9140 PW4NWG DEpT SR 3 C.S. 2305 Access Connection Permit M93-021 Mile Post 27.71 Right E.C. File #92602 - M Dear Helm: Attached is your executed ong' al Access Connection Permit allowing you to perform the indicated work within the state highway right-of-way. The bonding requirement of this permit is satisfied by a $2,000.00 "Assignment of Escrow" at the "Olympia Federal Savings" in Belfair, WA., and shall be held until all work under this permit has been completed and approved by the Department. Before beginning work on this approach, please contact both the Area Maintenance Superintendent and the Utility Underground Locate Center to advise them of your planned work, starting date, and location. The Area Maintenance Superintendent's phone number is on front of the Special Provision page, and the Utility Underground Locate Center phone number is 1-800-424-5555. No work is authorized within the state highway right-of-way until this notice is given. Upon completion of this approach the Grantee will need to make a written request for inspection and release of escrow as provided under Special Provision No. 22 to the Area Maintenance Superintendent. It is your responsibility to provide any release of escrow forms required by"Olympia Federal Savings". Sincerely s ;j r,R of DAVID B. HILDERBRANT, P.E. Assistant Transportation Planning Engineer DBH TLS _cc:�=Mason County cc: M. McGill C a � Washington State ►�°°�� Connection Access Conn ' Department of Transportation on Permit cs 2305 SR 3 Permit NOM93-021 District No. 3 Name and Address of Applicant: North Mason United Methodist Church c/o Robert Helm P.O. Box 1197 Belfair, WA 98528 Phone: (206) 698-9140 The Applicant, hereinafter referred to as the "Grantee,"having applied for a permit to construct, use, and maintain a Type "D" (SU and Less) road approach to serve a church complex and parking lot only, at Mile Post 27.71, right side, located in the Southwest 1/4 of the Southeast 1/4 of Section 21, Township 23 North, Range 1 West, W.M., on a portion of State Route No. 3 in Mason County, Washington,the Washington State Department of Transportation or its designee, hereinafter referred to as the "Department," hereby orders that this permit be granted,subject to the terms and provisions stated upon the reverse hereof and Exhibits attached hereto and by this reference made a part hereof: Exhibit "A"— Special Provisions for Highway Encroachments, Pages 1, 2, & 3 Exhibit "B". Site plan showing access point. One page Exhibit "C". Traffic Control Plan. Pages 1 and 2 NOTE: No other access will be granted from the State Route to this property. This permit shall be void unless the construction herein contemplated is started within 90 days of issuance and completed within 120 days of issuance, unless otherwise provided herein. completion date: March 31, 1994 This permit is accepted and approved by the Grantee subject to the terms and provisions as herein set forth. GRANTEE DEPARTMENT OF TRANSPORTATION By: By: Title:Ch-mrn, A)M eJ MC &ftap OF 1 Lahti- ' TitleA.ssistant Transportation Planning Engineer Date: '¢ Date of Issuance: J Z 7 1 q DOT Form 224-OOSX(from) 7/92 w General Provisions x 1. The Grantee,its successors and assigns,agrees to protect the State of Washington,its officers and employees and save them harmless from all claims, actions or damages of every kind and description which may accrue to or be suffered by any person,persons,or property by reason of the acts or omissions of the Grantee,its assigns,agents,contractors,licensees,employees or any person whomsoever,in connection with Grantee's,its assigns', agents',contractors',licensees'or employees'construction,installation,maintenance,operation,use oroccupancyof the right of way or in the exercise of this permit. In case any suit or action is brought against the State of Washington,its officers and employees,arising out of or by reason of any of the above causes,the Grantee,its successors or assigns will,upon notice of such action,defend the same at its sole cost and expense and satisfy any judgement against the State of Washington,its officers,or employees: PROVIDED,that if the claims or damages are caused by or result from the concurrent negligence of(a)the State of Washington's agents or employees and(b)the Grantee or Grantee's agents or employees,this indemnity provision shall be valid and enforceable only to the extent of the negligence of the Grantee or the Grantee's agents or employees. The Grantee,and on behalf of its assigns,agents,licensees,contractors and employees agrees to waive any claims for losses,expenses,damages or lost revenues incurred by it or its agents, contractors, licensees, employees or customers in connection with Grantee's, its assigns', agents', contractors%licensees'or employees'construction,installation,maintenance,operation,use or occupancy of the right of way or in the exercise of this permit against the State of Washington,its agents or employees except the reasonable costs of repair to property resulting from the negligent injury or damage to Grantee's property by the State of Washington,its agents,contractors or employees. 2. During the progress of the work,such barriers shall be erected and maintained as may be necessary or as may be directed for the protection of the traveling public;the barriers shall be properly lighted at night. 3. Except as herein authorized,no excavation shall be made or ubstacle placed within the limits of the State highway in such a manner as to interfere with the travel over said road. 4. If the work done under this permit interferes in any way with the drainage of the State highway,the Grantee shall wholly and at its own expense make such provision as the Department may direct to take care of said drainage. 5. On completion of said work herein contemplated,all rubbish and debris shall be immediately removed and the roadway and roadside shall be left neat and presentable and satisfactory to the Department. 6. The cost of construction or modification of a connection shall be the responsibility of the Grantee,including the cost of modification of any connection required as a result of changes in property site use in accordance with WAC 468-51-110. 7. The Department hereby reserves the right to order the change of location or the removal of any structure or structures authorized by this permit at any time,said change or removal to be made at the sole expense of the party or parties to whom this permit is issued,or their successors and assigns. 8. Existing permitted connections impacted by the Department's work program and which, in the consideration of the Department, necessitate modification,relocation,or replacement in order to meet current Department connection location,quantity,spacing,and design standards,shall be modified,relocated,or replaced in kind by the Department at no cost to the Grantee. The cost of further enhancements or modification to the altered, relocated,or replaced connections desired by the Grantee shall be the responsibility of the Grantee. 9. If any changes are made or proposed in the land use,intensity of development,type of traffic,or traffic flow of the property served by this connection permit,the grantee is required to contact the Department to determine if further analysis is needed to determine if the change is significant and would require a new permit and modifications to the connection. . 10 All such changes, reconstruction,or relocation by the Grantee shall be done in such manner as will cause the least interference with any of the Department's work,and the Department shall in no wise be held liable for any damage to the Grantee by reason of any such work by the Department, its agents or representatives,or by the exercise of any rights by the Department upon roads,streets,public places,or structures in question. 11 This permitor privilege shall not be deemed orheld to be an exclusive one and shall not prohibitthe Departmentfrom granting other permits orf ranchise rights of like or other nature to other public or private companies or individuals,nor shall it prevent the Department from using any of its roads,streets, or public places,or affect its right to full supervision and control over all or any part of them,none of which is hereby surrendered. 12, The Department may revoke,amend,orcancel this permitor anyof the provisions thereof at anytime by giving written notice to the Grantee.The Grantee shall immediately remove all facilities from the right of way.Any facilities remaining upon the right of way 30 days after written notice of cancellation shall be removed by the Department at the expense of the Grantee. 13, It is the responsibilityot the applicant or Grantee toobtain anyotherlocal permits or other agency approvalsthat maybe required,including satisfaction of all environmental regulations. It is also the responsibility of the Grantee to acquire any property rights necessary to provide continuity from the applicant's property to the Department's right-of-way if the Grantee's property does not abut the right of way. 14. The party or parties to whom this permit is issued shall maintain at its or their sole expense the structure or object for which this permit is granted in a condition satisfactory to the Department. 15. Any breach of any of the conditions and requirements herein made,or failure on the part of the Grantee of this permit to proceed with due diligence and in good faith after its acceptance,with construction work hereunder,shall subject this permit to cancellation as herein provided. 16, This permit is subject to all applicable provisions of 468-51 WAC, Chapter 47.50 RCW, Chapter 47.32 RCW, and/or Chapter 47.44 RCW and amendments thereto. DOT Form 224.005X(back) 7/92 Washington State Special Provisions for Department of Transportation Highway Encroachments Permit No. M93-021 Applicable provisions are denoted by (X) $ 1. No work provided for herein shall be performed until the Grantee is authorized by the following Department representative: Marvin (Casey) McGill Area Maintenance Superintendent 8293 Spring Creek Road, Port Orchard, Washington 98366-9613 Phone: (206) 895-4753 X 2. Prior to the beginning of construction, a reconstruction conference shall be held at which the Department and the Grantee P P and Grantee's engineer, contractor, and inspector shall be present. X 3. Should the Grantee choose to perform the work outlined herein with other than its own forces,a representative of the Grantee shall be present at all times unless otherwise agreed to by the District representative. All contact between the Department and the Grantee's contractor shall be through the representative of the Grantee.Where the Grantee chooses to perform the work with its own forces, it may elect to appoint one of its own employees engaged in the construction as its representative. Failure to comply with this provision shall be grounds for restricting any further work by the Grantee within the State right of way until said requirement is met. The Grantee, at its own expense, shall adequately police and supervise all work on the above described project by itself,its contractor,subcontractor,agent,and others,so as not to endanger or injure any person or property. sz 4. A copy of the permit must be on the job site and protected from the elements at all times during any of the construction authorized by said permit. 5. This permit does not give the Grantee or any agent or contractor of the Grantee any rights to cut, spray, retard, remove, destroy,damage,disfigure or in any way modify the physical condition of any vegetative material located on the highway right of way, except by written permission from the Department or for purposes as described by No. 6 if denoted below. All restoration shall be done to the satisfaction of the Department at the sole expense of the Grantee. 6. If necessary to increase sight distance, brush shall be removed from both sides of the access connection and stumps shall be removed. The indiscriminate cutting of merchantable timber or disfiguring of any feature of scenic value shall not be permitted. 7. The access connection(s)shall be constructed in accordance with the attached Sufficient length of -inch diameter culvert pipe shall be placed in ditch and laid to a true line and grade.The access connection(s)shall be surfaced to the limits as shown on the plan with a 6-inch minimum compacted depth of gravel base material and a 3-inch compacted depth of crushed surfacing top course. Asphalt paving will not be required. Finished grade of the access connection shall be in accordance with the profile control as shown on the attached plan. Directing of surface water from private property to Department right of way will not be permitted, unless otherwise approved by the Department. �k 8. The access connection(s)shall be constructed in accordance with the attached Type °D° Plate (SU & Less) Sufficient length of NSA -inch diameter culvert pipe shall be placed in ditch and laid to a true line and grade. The access connection(s)shall be surfaced to the limits as shown on the plan with a 6-inch minimum compacted depth of gravel base material a 3-inch minimum compacted depth of crushed surfacing top course and paved with a 3-inch minimum compacted depth of Asphaltic Concrete Class B unless otherwise specified by the Department. Any existing oil mat on shoulder or roadway shall be removed and new pavement laid to a butt joint with existing pavement. Finished grade of new pavement shall be in accordance with the profile control as shown on attached plan. Directing of surface water from private property onto Department right of way will not be permitted, unless otherwise approved by the Department. JAI 9. All buildings and appurtenances shall be so located at a distance from the right of way line of any State Highway that none of the right of way therefore is required for use of the patrons or customers of any such establishment.Grantee shall comply with local building codes.Set-back requirements for the location of buildings in relation to the right of way line are a function of local authorities, and they should be consulted regarding requirements that must be adhered to. DOT Form 224-713X Page 1 Remised 9/92 Exhibit "A° ® 10. The Grantee agrees to schedule the work herein referred to and perform said work in such a manner as not to delay the Department's contractor in the performance of his contract. It 11. Work within the right of way shall be restricted to between the hours of 8:30AM and 4:30PM , and no work shall be allowed on the right of way Saturday,Sunday,or holidays, unless authorized by the Department.Any lane closures must be submitted for approval in advance of use. The hours of permitted closure may differ from the above noted hours. K 12. The shoulders,where disturbed, shall be surfaced with crushed surfacing top course three -inch minimum compacted depth,or as directed by the Department.The surface of the finished shoulder shall slope down from the edge of pavement at the rate of inch per foot unless otherwise directed.The restored shoulder must not have any strips or sections less than 2 feet wide. The restored shoulder shall be surfaced with asphalt concrete pavement. ® 13. The Grantee shall be responsible for constructing and maintaining the access connection(s) and appurtenances between the shoulder line of the highway and the right of way line inclusive of surfacing and drainage.The Department has the right to inspect all installations at the time of construction and at any time afterward and to require that necessary changes and repairs be made. Unsatisfactory work will be corrected by the Department, at the Grantee's expense, or access may be removed at the Grantee's expense.Directing of surface water from private property onto Department right of way will not be permitted. ® 14. The access connection shall be sufficiently surfaced back an adequate distance from the edge of the pavement to prevent any tracking of material onto the highway.Any tracking of material onto the highway shall be subject to enforcement of Chapter 46.61.655 RCW and shall be immediately cleaned up by the Grantee or the Grantee's agent. 15. Standard highway warning signs designated as "Truck Crossing" sign, plate W11-6, shall be placed and maintained at Grantee's expense on each sideof the access connection.Signs shall be in evidence only when access is actually being used. If necessary,flagmen shall be provided.Sufficient parking space shall be provided by the Grantee outside Department right of way so no vehicles will be parked on said right of way. X 16. All manholes,valve covers,and like appurtenances shall be constructed at such an elevation to conform to the shoulder slope from the edge of pavement or as directed by the Department. 17. All slopes, slope treatment,top soil, ditches, pipes, etc.,disturbed by this operation shall be restored to their original cross section and condition. All hazards shall be marked by warning signs, barricades, and lights. if necessary,flagmen shall be employed for the purpose of protecting the traveling public. Roadside operations shall be specified by the Department's representative. 18. During the construction and/or maintenance of this facility, the Grantee shall comply with the Manual on Uniform Traffic Control Devices for Streets and Highways. If determined necessary by the Department,the Grantee shall submit a signing and traffic control plan to the Department's representative for approval prior to construction or maintenance operations. 19. Bond coverage required to ensure proper compliance with all terms and conditions of said permit will befurnished by a Blanket Surety Bond held at Headquarters in Olympia. .A 20. A surety bond in the amount of$ 2,000.00 written by a surety company authorized to do business in the State of Washington,shall be furnished to ensure compliance with any and all of the terms and conditions of this permit and shall remain in force until all work under this permit has been completed and approved by the Department. �X 21. Relative to advertising adjacent to all State highways,we wish to call your attention to the Scenic Vistas Act of 1971,Chapter 47.42 RCrd anu State Transportation Commission ruling Chapter 468-66 WAC. Violation of this section of the statutes will be sufficient cause for cancellation of this permit. On-premise signs are allowed. f� 22. The Grantee shall notify the Department's representative upon completion of the work under this permit so that a final inspection can be made. X 23. No lane closures shall be allowed except as approved by the Department representative. Approvals may cause revision of special provisions, including hours of operation. ,® 24. The responsibility of the Grantee for proper performance,safe conduct,and adequate policing and supervision of the project shall not be lessened or otherwise affected by Department approval of plans, specifications,or work,or by the presence at the work site of Department representatives,or by compliance by the Grantee with any requests or recommendations made by such representatives. N 25. All material and workmanship shall conform to the Washington State Department of Transportation Standard Specifications for Road, Bridge and Municipal Construction, current edition, and shall be subject to inspection by the Department. ADDITIONAL "SPECIAL PROVISIONS" SEE PAGE 3. DOT Form 224-713X Page 2 Exhibit "A" Revised 9/92 i Page 3 of 3 M93-021 North Mason United Methodist Church c/o Robert Helm P.O. Box 1197 Belfair, WA 98525 Special Provisions (Continued) X 26. Any future development of this property or change in land use will require review and approval by both WSDOT and Mason County for adequacy of this approach for the intended use. X 27. The Grantee is responsible for all coordination, work, and expenses associated with any utility relocation. X 28. This approach shall be constructed, adjacent to the Northeast property line, to meet the current type "D" road approach standards and aligned 90 degrees to the centerline of highway. The down slope from the edge of pavement, out a minimum of the shoulder width plus a foot shall be constructed at a minus 0.05 feet/foot down and away from the highway. Any problems created by surface water runoff directed toward the state highway must be alleviated at the Grantee's expense. Please review the type "D" templates for details for SU and Less. X 29. Asphalt paving of this access shall be extended from the shoulder line of SR 3 out to the right-of-way line at the Grantee's expense. All materials used within the state right-of-way shall be to WSDOT standards. X 30. The Grantee shall use the approved traffic control plans as provided in Exhibit "C". It is the Grantee's responsibility to provide adequate traffic control and protection to ensure the safety of the traveling public, all personnel, and equipment, working within the state right-of-way. If necessary, the Grantee shall provide certified flaggers for the purpose of protecting the traveling public. X 31. Any proposed landscaping or fencing within the Department's right-of-way must not infringe on the sight distance or the roadside clear zone. The disturbed area within the Department's right-of-way shall be contoured, graded, seeded, fertilized, and mulched at the .Grantee's expense to reduce erosion and problems with surface drainage. X 32. Bonding will be held on this approach until all work is completed to the satisfaction of the Department. X 33. The Grantee is responsible for obtaining a construction permit and all other pertinent permits from Mason County or other agencies, if applicable, prior to beginning work. X 34. There will be no advertising signs or bill boards erected within the state right-of-way. X 35. The Grantee will clear the brush, small trees, branches, and undergrowth, on both sides of the approach to improve sight distance. sic Pp14wA� u��e�T As a�t< �,.�o -ro ,►� Accc.%s IS O•'3 vrF srre oa+►�wee.� -ft eowt,yua mllas SOUTH OF \ M" posT2g r x / � JI A raFS t �I 3. o ___Hosts . -'A) ALL Wp&A*Wl s SwWAWDIOWI o -Te-ON SM INPI og 1powAtS t z _® A� C.r. " A 14AS Sty AOU4060 AY NA.71Y19 b"WTN wil�ER.S• —1�10 f.URtA� DRAW et.C- 'p LZMIL�-a I T&_ - ' i '' _Aod►O�IpG-PI►Mt�A�. Ait+i�'7'lP ►��•1 -�ft71�_MQ_C.a�/i/1,t _ . ,�Y �����6 w►-�a,-- : _- - EXHIBIT „6„ , .;; ;aZ'1 = wRa��kftY Un+-zoNla J ® v e HICK TrUI P5 i s-n MATE D ' _..ZITATIM HI WA VJA•Y C:d3) AOAD Aer-ASS PLAA yin _ r + p/p/ ° #*A to y -:�� y�- _ TWDA70 M4SON.MET1,45off CN. / [fA...- P4 3) SOMA-( - ILO Tn-Irs/vIN( CAT[ s- if•q? �vN[e Loc.fa•f IM 0 NoaTM OF 9EL-FAIR 404 'TeA CAST s'y � T oF3sf l WY 3 0!3 MlMs OF SKL Po,Ser�28 oa.• vb. .a.11.M Too a !� a: GENERAL MOTES ? Fbodlghts inCA be 0,0r1 ed to*Crk Madder ffatbM of nlG�f as M•C•C. If Mtlre•oru ar•p la rlAide fro•' C^• o station•one floGoer Tc'IN,."e. v` tZG To Steady b-.I N) •o,nln;Ildrrti ITTPE C.1•U iCCI Y sr-Ad a• ..d fa�M w cno—."I c C•ric•• aT nIQnT as M•Ceo. Rm-w Crw wwlilnp devices cre to be•+tencea -o a�•� 6E o,fic.n•r• tn•r e-e rbld• to eo>•e<:n�n;J troffic. /R PREPARED slgT seawnce Is tM s:,e for born TO alr•ono..•of •^p.el. • �♦ STCo e20•. 1- ONE I PNC' ROAO AHEAD P1311 rt� RDv t CON..iRlr-1.,, OR AuKNCt WAR. RutR-9� J %� Ey AeLf AOvVG a o o CNAa�E.l2 NG DEnCES TRAFFIC CONTROL PLAN ALTERNATING ONE-WAT TRAFFIC Yr•t ItD.AIb AROJ.ro. PROGRAM DEVELOPMENT -�css:uw c'g+to-- 10 Ir•fle DIVISION �!PAigh,rasningron Srare IT Y�-f— ut " r71Oi Y AFFIC CONTROL PLAN NIIIIMl11 TAPER LEeGtw (LI IN FEET Posted Speed (.Ohl 2S 70 SS 4 0 .s so ss 10 1as ISO 205 2TO .SO 1 S00 Sso =11 IIS lis x2S 27S en SSO ws 1 12s Li0 2NS 720 540 wo KO F ► O o O N RK O � AREA X X L/S Buffer vehic:s Sign Spdcirq. , with fldfnerd Urdl Fads .0/SS NP11 Ur DOn Ar ter iOlf ROAD RIGHT (ppf1pr1o1) U,odn Stree rs CONSTRUCTION SHOULDER F.,iaMtldi ► 2—s wN 2so' CLOSED AHEAD AHEAD N20 -1 N20 -S 40D. i GENERAL ROTES sooting D.tr..M ci,—.l:iing I dev rou io d raper ahwla De a.arlT.w.a In feet 10 the geed 1(.i tl the so. WORK be'-.-.noon.-i.i,g d..lc.,Ines i t0,.P-ore 1roffic ,ndrld be 2 ti1n.] in. speed li.ir. N2t- <g> I LEGEND I a a a CHANNELiZV+G DEVICES I SHOULDER CLOSURE I —IS r.TE FED..to PRa.No' PROGRAM DEVELOPMENT ,NED NT 10 MASH DIVISION ®Washington State tic" Deportment of Transportation EXHIBIT zz (. _ENGII. ow.., TRAFFIC CONTROL PLAN ENGR DATE DATE REVISIOR BF ..ra N O Right-Of-Way Variable Standard Shoulder Plus 1' I Curb As Required -0.05 Ft./Ft. r =Edge Of Pavement 8% MAX .0 ,Ootfh',8Js4*Ai-AOoir ji nIIN CA"Wi4e Wam*ttat, PROFILE CONTROLS r a M I ; C A0 J' 5 c = o� r�3 _o E o CL Q Z �L ! , � Right-Of-Way Line no• Right-Of-Way Line� 9 Y t Paving Limit � ; Im 0 A E Shld.Line I a 1:25 Taper To Existing ' Shld. Line 1:25 Toper To Existing --- To B a 15'MIN _I .,9. n ------------------------ h , _ 15'MIN Asphalt Concrete Povement —q State Hwy Edge Of Pavement m Condition A 8 I C D E F G H I Primarily SU L Less — — 10' 30' 15' — — 30' 10' Primary Combination Vehicle WB 40 10', — — 0' C Primary Combination Vehicle WB 50 d Doubles 70' —, [�!E 0' 10' Primary Combination Vehicle WB 63 8' ' 4 ' 0 3 `O c Jew ASSIGNMENT OF dWHOW ACCOUNT This assignment is for the purpose of fulfilling the requirement of bonding collateral for Permit M93-021 The undersigned does hereby assign, transfer, and set over unto the State of Washin ton all right, title Sic- and interest in and to $2,000.00 on /Account in the 10 Q AP� /-SZrOFABank, in the name of North Mason United Methodist Cuhrch full power and authority to demand, collect, and receive said deposit and to give receipt and acquittance therefor for the uses and purposes prescribed above. It is understood and agreed that L��1>�[/•� Branch, all22j O � (�y� Bank holds the Certificate covering said account in its possession and agrees to hold $2, 000.00 until a release of this assignment from the State of Washington is received. The interest- shall be payable to North Mason //United Methodist Cuhrch Signed and dated at Washington this day of 199 Account No. Sign re ignatur P,O t 8ox l l 17 B e(4914- , w R Address ACCEPTANCE The undersigned hereby accepts the foregoing Assignment of - Rw-Certificate, r Number E}3�L2-r' .3.�i-y- in the amount of 52, 000.00 this day of U 199 _d� ow, &act,,- CX Ff Sav�n Esei"AW Officer 14 i Zac� t1S- I�oo l P v x 33"► e �� ,0 - Phone No. of Bank Address of Bank C1fC�^