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HomeMy WebLinkAboutRAP6191 - RAP Permit / Conditions - 11/27/1996 6 / PERMIT Pv�.N0 Mason County Road Department Permit Number: 6191 411 North Fifth Road Name : Larson Lake \� P.O. Box 1850 Road Number : 85870 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 Ron Logan Hereby Granted To: P.O. Box 2079 Shelton, WA 98584 426-9918 To Install: single family access Location: NE 1041 Larson Lake Road - very visible. Parcel Number: 12330-53-00033- Legal Description: Lot 33 Beard' s Cove 6 A bond in the amount of $ N/A accompanies this permit . Receipt Number: Check Number: Contractor : JIMINI Inc. Address : same as above City/St/Zip: Phone : 426- Lic. Number: JIMINI*0770 Expires: 08/01/97 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: