HomeMy WebLinkAboutRAP - RAP Application - 11/6/1993 Road No: ay
Road Name: J0 C
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: 'ROO Got D
Address: l 31 L LAC, L" �2lz:1{Fe_TDO C�83ia Phone: 3rj1 - 6o5�(,
To install a ReS , (� W&E:: — Slr\'V
Location: �_A-RSoy t_1L ::rAKE iZT b iJ 7Z�;U,�?
Legal Description: 3eAe-ADS Coves '-Diu S L-CT Co3
REMARKS:
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Culvert Specifications: Culvert to bet rate or polyethylene.
Culvert to be mi12' diameter by 20' length.
Culvert will lay i OfA
Access to be grave line with 3" of clean gravel.
A Bond in the amount of $ a ccompanies this permit.
(Rct. # 0 7q Check Imo_. )
Contractor: Address:
Phone: License Noy: 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
P p
completed on or before 19
DATED at Shelton, Washington, this day of 19
Issued by:
Title:
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