HomeMy WebLinkAboutRAP9618 - RAP Permit / Conditions - 5/12/2003 0601 PERMIT Jde,+--%CE1VED
Mason County Road Department Permit Number:
411 North Fifth Road Name :
P.O. Box 1850 Road Number : NbY�-hS�►.�MASONCOUNTY PUBLIC WORKc
Shelton, WA 98584 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is riq k Y -rd CK/- P
Hereby Granted To: lepa
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To Install: a7 / - 3V33 CC)
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Location: - FN 50D 1- ltj %zMl L, r�
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Parcel Number: 81W,0-f Cove Di✓ Y Co r' /s
Legal Description: A �eRTICN pF ,✓ yz - se y
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A bond in the amount of $ o75- a accompanies this permit.
Receipt Number: Check Number:
Contractor
Address
City/St/Zip:
Phone
Lic. Number: Expires:
Specifications:
Access to be graveled to property line with 3"depth of dean gravel. Culvert to be aluminum,concrete or polyethylene.
Access will be staked and flagged by Permittee for pre-inspection. Culvert will lay in fine 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.
CommercW/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: 360-427-9670 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:
Dated at Shelton, Washington, this day of ,
Issued by:
Title: