HomeMy WebLinkAboutRAP4094 - RAP Permit / Conditions - 3/29/1994 j ACCESS PERMIT
Mason Count Road Department Permit Numbers 4094
411 North Fif h Road Name : Olde Lyme
P.O. Box 185 Road Number : 53490
Shelton, WA 8584 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is Jan Stimach/ Kelley Bueschel
Hereby Granted To: P.O. Box 1653
Sheltom 98584
426-1880
To Install: single family access
Location: Corner of Old Lyme and Kilmarnock - see attached map.
Parcel Number: � L� )J -) 54 00C)l
Legal Description: Lake Limerick Division 5, Lot 73 .
A bond in the amount of $ 25 . 00 accompanies this permit .
Receipt Number: 13389 Check Number: 1063
Contractor :
Address :
City/St/Zip:
Phone : 426-
Lic. Number: Expires:
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 Psrmittes for pre-inspection. Culvert wig lay in line of ditch.
Access will be pro-inspected by this office prior to installation. Culvert to be minimum of 12" diameter by 20' length.
Access installation shad be in accordance with county specifications.
Commercial/Multi use access shad 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: