HomeMy WebLinkAboutRAP5047 - RAP Permit / Conditions - 3/13/1995 Road No: 410
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Road Name: fit- 16r
W, X,— MASON COUNTY ROAD DEPARTMENT
411 North Fifth
Shelton, WA 98584
'J
PERMIT
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: ��1Z
Address:/()L 70 / w ; SS1'o.l C`f -1 (3fzfA Phone: Z�s�735�
To install a a,
Location: /tJ� (OS / ANsav, �l'Ucf /�� IZ?
Legal Description:
REMARKS:
Culvert Specifications: Culvert to be metal, concrete or polyethylene.
Culvert to be mininum 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 $ �f ... accompanies this permit.
(Rct. # Chec1k #cJ )
Contractor: S-1 e �Ge� c�GtH"'C Address: //L)C 20
Phone: � � Zc/_ License No: Expires:
* Access w01 be staked and flagged by Permittee for pre-inspection.
* Access wi11 be pre-inspected by this office prior to installation.
* Access installation sha11 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: