HomeMy WebLinkAboutRAP9966 - RAP Permit / Conditions _ PERMIT A � I' LL' zja
M o Co oad Department Permit Number: 9966
loco
tg IIS
Road Name Clonakilty D
Melton, Road Number 54170
A 84 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is John Potter
Hereby Granted To: 11842 14th Ave S
Seattle, WA 98168
439-8072
To Install: single family access
Location: Go out Mason Lake road, turn right onto Clonakilty Drive and turn
right into cul-da-sac .
Parcel Number: 32127-54-00050-
Legal Description: Lake Limerick 5, Lot 50
A bond in the amount of $ 25 . 00 accompanies this permit .
Receipt Number: 20678 Check Number: Cash
Contractor
Address
City/St/Zip:
Phone : 426-
Lic. Number: Expires:
Specifications:
Access to be graveled to property line with 3" depth of clean 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 30' length.
Access must be perpendicular(90 degrees)to the County Road.
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 : 360-427-9670 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 :
Dated at Shelton, Washington, this day of ,
Issued by:
Title .