HomeMy WebLinkAboutRAP - RAP Application - 7/28/1992 Road No:
Road Name: r0 CKdoL/-e
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: 1�onczl d l.� • Cons�ance J .Sang."
Address: 5 3 7 10es t T Phone: ���o'Cv� � 7
To install a CCU U>✓r� S C
Location: ro c,
Legal Description: of �ViS 0� /U0.�O rrC rAeA
?/akl9a . 1Jgd;4Vr S F/e-AJo 55- g-'s 7 e a. D r7`i Oyt Doc' die 5o. 1�a�Fo F
G S 8 rester of Sccf;on toles i-✓•n''
REMARKS.
Culvert Specifications: Culvert to be metal, 64C to olyethylene.
Culvert to be m' ' diameter by 20' length. �a�31_ y q_,Ippa d
Culvert will lay ' ch. 'r�,30� aao
Access to be grave property fine with 3' of clean gravel. �O
A Bond in the amount of $"�5 U0 accompanies this permit.
Check
(Rct. # �7 • �
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 1aave been
completed on or before
DATED at Shelton, Washington, this day of 19
Issued by:
Title: