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HomeMy WebLinkAboutRAP4312 see 2 parcels - RAP Permit / Conditions - 10/25/1994 ACCESS PERMIT _ Mason Countv Road Department Permit Number: 4312 r / 411 North Fifth Road Name : Old Belfair Highway P.O. BOX 1850 Road Number : 98250 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 Coppany. Aprox" 40 ' in width. Will be staked and flagged. -4 C'K OdIc71s aCU/,� Parcel Number: 12317-41-00060- Legal Description: 11K,' (P 4 ry F— A bond in the amount of $ 50 . 00 accompanies this permit . Receipt Number: 13944 Check Number: 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 "All 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 P7� > n Revised 10/6/94 Part A: Nature of Complaint ! • Initiator's Name: • Address: • Telephone: , • Owner Name: • Address: A L 20SS F Rp ht �/ �� O L t FA t 12- Z • Telephone: • Department of Concern ❑ Clerical ❑ Building ❑ Health ❑ Comm Development ❑ Fire • Area of Concern: ❑ Process Delay ❑ Personnel ❑ Policy/Fee ❑ Code Violation ❑ Other v (� Refer to Director • Location of Concern: / C P©5S r 2-or►A 1SS) p titc_F#4tt ... z JY- T(2u.s� 0 o AA e r "Y • Nature of Concern: 0/Zt 7 F(x N 2- i>u tvP r f Zu t= (I ovan, at L r a 1(Z. S,4N4) AeJ Part B: Concern Intake and Referral Received By: Referred To: Response Date: Name Date Name Date Date Part C: Findings Referral Forwarded to: ❑N/A Name j Date Findings: '•fh e c x_)n Cr 0 o per 4,4 LA, Part D: Resolution Date Intake Copy-White File Copy-Yellow Referral Copy-Pink