HomeMy WebLinkAboutRAP4312 see 2 parcels - RAP Permit / Conditions - 10/25/1994 ACCESS PERMIT
Mason Count Road Department Permit Number: 4312
P O. BOX 18fi Road Number : 98d250elfair Highway
Shelton, WA 98584 Road Location:
Subject to all terms, conditions and provisions written or printed b w, \�
or on any part of this form, "\
Permission Is Chester Loudin \
Hereby Granted To: P.O. Box 1980
Belfair, WA 98528
275-7422
To Install: commercial use \�
Location: 1980 Old Belfair Highway - acccess o C4et ' s Truss CoRpany. Aprox.
40 ' in width. Will be staked and flagged. O� -4 6;'K 0&ci s QCCLV2.
Parcel Number: 12317-41-00060-
Legal Description: �� Q 4 t�E 'SF
A bond in the amount of $ 50 . 00 accompanies this permit.
Receipt Number: 13944 Check Number: C,
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,
INVESTIGATION REPORT FORM 1v 1 0)?3 n
Revised 10/6/94
Part A: Nature of Complaint
• Initiator's Name:
• Address:
• Telephone: 11im \
• Owner Name:
• Address: L ma-%s F it AA �� 0 LD L t.FA 1 12-
• Telephone:
• Department of Concern
❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire
• Area of Concern: ( /�
❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other (A
Process
Refer to Director
• Location of Concern:
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•Nature of Concern:1 M d(Zt 7 t f 14 N /2- Liu/gyp r fZ�'C�--•�
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Part B: Concern Intake and Referral
Received By: Referred To: Response Date:
WA (ZR-t rJ
Name Date Name Date Date
Part C: Findings
Referral Forwarded to: ❑N/A
Name Date rr
Findings: ' h t�-fir Cr 0 aC Qc v u t r. e f aA�kf
CLOD( rJ, h
Part D: Resolution
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ame ( /—y + Date
Intake Copy-White File Copy-Yellow Referral Copy-Pink