HomeMy WebLinkAboutRAP6063 - RAP Permit / Conditions - 5/10/1996 PEST 1Q
Mason Count Road Department permit Number:
411 North F h Road Name :
P O Box Road Number :
Shelton, WA 8584 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is 9// QG�#�� R/�<, G� e�
Hereby Granted To: �lG��/A/� �EB�b
QUA ya
To Install:
Location: - -
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a u Lr ( yea 'Tk, u yA A10 , P)W,�s S T _
Parcel Number: 3 2-2 2 - ? d-06 (�D
Legal Description: 7-/Z 6 5a,),`,i y .Z/ /3�4
A bond in the amount of $ accompanies this permit .
Receipt Number: , zs�z 7� Check Number:
Contractor
Address
City/St/Zip:
Phone
Lic. Number: Expires:
Specifications:
Access to be graveled to property line with 3" depth of dean gravel. Culvert to be aluminum, concrete or polyethylww.
Access wi be staked and Nagged by Permittee for pre-irwpection. Culvert wN lay in liw of ditch.
Acoss wi be pre-irwpected by this office prior to irwtalation. Culvert to be minimum of 12" diameter by 20' length.
Access iwtalation shal be in eccordance with county specific-stk—a_
CommwcW/Muld use access shah require STOP Signs, istaled in conformance to the MUTCO manual, at intersection with county road.
No work shall be done under this permit until tine party to whom it is
granted has communicated with and received instructions from the road
supervisor at : 427 -9670 ext . 450 or at 1-800-562-5628 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 :
, 19
Dated at Shelton, Wa,3hington, this day of _ 19
Issued by:
Title.