HomeMy WebLinkAboutRAP Application Road No: 70390
Road Name: North Shore
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: Dan Dat Vu
Address: 15032 - 37th Ave. NE, Seattle, WA 98155 Phone: 365-9022
To install a multi -use access. I
Location: NE 11OXX North Shore Road was postLfor no accessin4r m,
Legal Description: see attached. On-J1,44 S St nin 5P_ BL616_zc Vh
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 mount of $ 50.00 accompanies this permit.
(Rct. # Jar7 q5 ; Check # !I 4�(- . )
Contractor: Pat Venglar Address:NE 6500 North Shore Road
Phone: .275-2558 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 have been
completed on or before 19
DATED at Shelton, Washington, this day of 19
Issued by:
Title: