HomeMy WebLinkAboutRAP - RAP Permit / Conditions 1 Road No: 53580
Road Name: Kilmarnock
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: Friedrich Zieseniss
Address: E 170 Kilmarnock, Shelton, Wa 98584 Phone: 509-997-5714
To install a single family access
Location: E 120 Kilmarnock
Legal Description: Div 5 Lot 89 Lake Limerick
REMARKS:
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be minimum of 12" diameter by 20' length.
Culvert will lay in line of ditch.
Access to be graveled to property line with 3" of clean gravel.
A Bond in the amount of $ 25.00 accompanies this permit.
(Rct. # 12993 Check # 116 . )
Contractor: Address: Phone:
License No: 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:
Title: