HomeMy WebLinkAboutRAP4125 - RAP Permit / Conditions - 4/27/1994 Road No: 70950
• ' Road Name: Tahuya River Road \
MASON COUNTY ROAD DEPARTMENT
411 North Fifth 7 n i
Shelton, WA 98584 \\
PERMIT
r
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: Dennis Bogue
Address: P.O. Box 96, Tahuya, WA 98588 Phone: 275-2090
To install a single family, access.
Location: 1921 NE Tahuv-: Fiver Road
Legal Description: North 180' of the South 940' of the SE 1/4 of the SE 1/4
of Section 12, T. 22, North - Range 3 W.W.M.
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. # 15 4 ; Check # —10 0 11 . )
Contractor:JeNfV)_:!5 ,��Z&Address:_�D
Phone: 75 370?/ License No 1yZ)r1Q__1 Expires:
* Access will be staked and fiaggea by Permitree 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 acc;:ss shall require STOP sign, installed in
conformance to the MUTC,: 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 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:
CONTACT OFFICE WHEN ACCESS
IS COMPLETE FOR FINAL INSPECTION Title: