HomeMy WebLinkAboutRAP5140 - RAP Permit / Conditions - 6/7/1995 Road No:
Road Name:
�L�VZ T
MASON COUNTY ROAD DEPARTMEN -
�_ 1 O 411 North Fifth
s helton, WA 98584
9SQN COi�1TY ROB OE
PERMIT
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: oLTo 4 A
Address:- N, �jisson C. L�a Phone: ,2 2 ,i—
To install a J .2 '1
Location: JV , 14'
3 vv _ tii s s . ,n PR ` /9
Legal Description: a� /,� 3 3 --_90%/Y
REMARKS: l
i
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be mininun of 12" diameter by 20' length.
Culvert will lay in fine of ditch.
Access to be graveled to property line with 3" of clean gravel.
A Bond in the amount of $ accompanies this permit.
(Rct. # Che k # )
Contractor: 1 )--- p J�,A 4 UC a .s r 0 Address: A , J= 70
Phone: A7s' 3�/ License No: �P14 T- I�f;1J Expires: �„ _ / - 9,ti
* IV
Access will be staked and flagged by Permittee for pre-inspection.
* Access will be pre-inspected by this office prior to installation.
* Access installation shall be in accordance with county specifications.
* Commercial/multi use access shall require STOP sign, installed in
conformance to the MUTCD manual, at intersection with county road.
� e
No work shall b - done under this permit until the party or parties to whom it
is granted shah have communicated with, and received instructions from the
Road Supervisor , Phone: 427-9670 extension 450.
This permit shall be void unless the work herein contemplated shall have been
completed on or before 19
I
DATED at Shelton, Washington, this day of 19
Issued by:
Title: