HomeMy WebLinkAboutRAP94-00129 - RAP Permit / Conditions - 10/2/1995 Kudu IYU: f
�. Road Name:
MASON COUNTY ROAD DEPARTMENT }i(p S
411 North Fifth �1
Shelton, WA 98584 (1
PERMIT Lo
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: +PESC)V-"
Address: I (o S 0 2ri rr�� Phone: 14D 7—'_ 31T9
To install a
Location: a l of le rn Rc
Legal Description: I—OT a.a ` 1)oj L"'V��Ir-tC
�� rce,l Sal 53 - 33 o03a -�
REMARKS: ,�r I �P_ I 4—IGtCCi PCI
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be mininun of 12" diameter by 20' length.
Culvert will lay in fine of ditch.
Access to be graveled to property fine with 3" of clean gravel.
A Bond in the amount of $ accompanies this permit.
(Rct. # Check # .)
Contractor: -+-reckon Hcrnev `r Address: iL,5b�he4cr, SprLff4stzcl -G
Phone: 9 License No: TizEc64E iya N i 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:
CONTACT OFFICE WHEN ACCESS
IS COMPLETE FOR FINAL INSPECTION Title: