HomeMy WebLinkAboutRAP8926 - RAP Permit / Conditions - 3/2/1994 Road No: h
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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,
PERMISSIONN IS HEREBY GRANTED T0: CLC `�/l^-0 `� ��S �r��c_�-c� 3 �r�C
Address: POD Cr ) 'S�S ���
k ���-t� �f —Phone:__��
To install a L�J kg�S
Location:
Legal Description: � C_�D 02
REMARKS:
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be minmum of 12' diameter by 20' length.
Culvert wig lay in line of Etch.
Access to be graveled to property fine with r of clean gravel.
A Bond in the amount of $ _accompanies this permit.
(Rct. N Check # . )
Contractor: C_Dh Lc Address:
Phone: �n5—fl�_ 11 License No: 6 jz 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 14UTCD 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 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
CONTACT OFFICE WHEN ACCESS by:
IS COMPLETE FOR FINAL INSPECTION Title: