HomeMy WebLinkAboutRAP9730 - RAP Permit / Conditions - 2/28/2003 IN
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3 PERMIT �� �� �1
M o Cop oad Department Permit Number: 9730
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Road Name Elfendahl Pass
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Road Number 80610
Melton,VA84 Road Location:
Subject to all terms, conditions and provisions written or printed below
or on any part of this form,
Permission Is Bob Case
Hereby Granted To: P O Box 2210
Belfair WA 98528
275-0691
To Install: single family access
Location: 7291 Elfendahl Pass Road �aCG25S
Parcel Number: 22302-77-00020-
Legal Description: Lot 2 , Large Lot Subdivision #96-4
A bond in the amount of $ $25 . 00 accompanies this permit .
Receipt Number: 20213 Check Number: CASH
Contractor
Address
City/St/Zip:
Phone : 426-
Lic. Number: Expires :
Specifications:
Access to be graveled to property line with 3" depth of clean gravel. Culvert to be aluminum, concrete or polyethylene.
Access will be staked and flagged by Permittee for pre-inspection. Culvert will lay in line of ditch.
Access will be pre-inspected by this office prior to installation. Culvert to be minimum of 12"diameter by 30' length.
Access installation shall be in accordance with county specifications.
Commercial/Multi use access shall require STOP Signs, installed in conformance to the MUTCD manual, at intersection with county road.
No work shall be done under this permit until the party to whom it is
granted has communicated with and received instructions from the road
supervisor at : 360-427-9670 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 :
Dated at Shelton, Washington, this day of ,
Issued by:
Title .