HomeMy WebLinkAboutRoad No. 89100 - RAP Application Road No: 89100
Road Name: Larson Boulevard
MASON COUNTY ROAD DEPARTMENT
411 North Fifth
Shelton, WA 98584
PERMIT
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: George D. Holmgren
Address: P. 0. Box 748, Belfair, WA 98528 Phone: 275-5337
To install a single family access
Location: N.E. 710 Larson Boulevard (not posted 'on ground' )
Go up Sand Hill Road - take left on Larson Blvd. , o top of hilljust
past intersection with Larson Lake Road access i ht-hand side of road
r
Legal Description: Beards Cove Div. 6 Lo
Parcel #1233-053-00
REMARKS:
Culvert Specifications: Culvert to be metal, conac
e
Culvert to be minimum of er b 20' length.
Culvert will lay in line)
Access to be graveled to propert fine with 3" of clean gravel.
A Bond in the amount of $ 25.00 accompanies this permit.
(Rct. # 13011 Check # 1508 . )
Contractor: Address: Phone:
License No: Expires:
* 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.
No work shall be done under this permit until the party or parties to whom it
is granted shall 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
DATED at Shelton, Washington, this day of 19
Issued by:
Title: