HomeMy WebLinkAboutRAP - RAP Permit / Conditions ACCESS PERMIT
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411 NorthuFifh�ea° Department Permit Number:
P.O. Box 185 Road Name : Larson Boulevard
Shelton, WA 98584 Road Number : 89100
Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
P
Permission Is
Hereby Granted To: Russell W. Ford
P.O. Box 1074
Belfair, WA 98528
275-6917
To Install: single family access
Location: Two accesses - one is 120 ' from intersection with Schooner
one located 60 ' from Schooner Loop (the second one is to be temporary-see
attached) . over Loop and
Parcel Number: 22330-51-00044-
Legal Description: Lot 44 of Beards Cove No. 4
A bond in the amount of $ 50 . 00
accompanies this permit .
Receipt Number; 13113
Check Number; 3263
Contractor :
Address :
City/St/Zip:
Phone : 426-
Lic. Number:
Expires:
Specifications
Access to be graveled to Property lire with 3" depth of dean gravel.
Access will be staked and flaggedCulvert to by Permittee for Pre-in be aluminum, concrete or Polyethylene.
Access will be Pre-inspected b Culvert will la y this office prior to installation. Y in line of ditch.
Access installation sham be in accordance with co Culvert to be m'
unty specification minimum of 12"diameter by 20' length.
Commercial/Multi use access shall require STOP Sign, "tailed in conformance to the MUTCD manual, at intersection with count
y road.
No work shall be done under this permit until the art
s f� hom thel
om road
supervisor at : 427-9670 ext . 450 or at 1-800-562-5628 ext . 450 .
granted has communicated with and received instructions
RESULTS OF SITE INSPECTION: See Attachment "A"
This p ermit shall be void and bond forfeited to Mason County unless
work herein contemplated shall have been completed
19 on or before: the
Dated at Shelton, Washington, this
day of 19
Issued by:
Title: