HomeMy WebLinkAboutRAP5255 - RAP Permit / Conditions - 12/4/1995 PERMIT
Mason County Road Department Permit Number: 5255
411 North Fifth Road Name Mason Lake l
P.O. Box 1850 Road Number :
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 George Simms
Hereby Granted To: SE 3350 Arcadia
Shelton, WA 98584
426-2558
To Install: single family access
Location: E 2580 Mason Lake Road - will be staked and flagged.
Parcel Number:
Legal Description: Division 4, Lot 170, Lake Limerick
A bond in the amount of $ N/A accompanies this permit.
Receipt Number: Check Number:
Contractor : Daves Const. & Concrete
Address : SE 3350 Arcadia Road
City/St/Zip: Shelton, WA 98584
Phone : 426-2558
Lic. Number: DAVESCC266K Expires: 05/09/96
Specifications:
Access to be graveled to property line with 3"depth of dean 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:
1
Road No:
Road Name: �� a�cr. L a
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: Janet L. Stimach
Address: 1920 South Spokane St. Seattle, WA 98144 Phone: 722-7978
To install a single family access \
Location: .',,
Legal Description: L V, L
REMARKS: ' �,� ' > L
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be minirncm of 12' diameter by 20' lerpth.
Culvert will lay in line of ditch.
Access to be graveled to property fine with 3' of clean gravel.
A Bond in the amount of $ N/A accompanies this permit.
(Rct. # ; Check # . )
Contractor: ;dr,, Alerle T(uc(,-, L, Address: SlC JZid h�4 6[it6cIVA
Phone: y2-'7- � 7 `iC. LicenSO No: c�c icr U ?, 7 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 Allan Eaton , Phone: 427-9670 extension 450.
This permit shall be void unless the work herein enntpmnlatari shall have been
completed on or before 19
DATED at Shelton, Washington, this � . ay of 19`
Iss„ed by:
CONTACT OFFICE WHEN ACCESS
IS COMPLETE FOR FINAL INSPECTION Tito: