HomeMy WebLinkAboutRAP Application Road No: 14410
Road Name: Bloomfield Road
MASON COUNTY ROAD DEPARTMENT
411 North Fifth
Shelton, WA 98584 /910-_ 0000
PERMIT
Subject to all terms, conditions and provisions written or printed below or on
any part of this form,
PERMISSION IS HEREBY GRANTED TO: Harris Watson_
Address:_ 1319 Kennewick Ave._ Renton 98055 Phone: 255-8691
To install a Sin le famil access
Location: jj4mL down Bloomfield Road on deft-hand side
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Legal Description: 1049-8 SW Sf
REMARKS:S: '
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Culvert cif cot" : Culvert to be metaL concrete or poyethbet
Culvert to be rnimrn of 12 tty 2O
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Acs to to gravelad wftivV of can grovel..,
A Bond in the amount of accompanies this permit.
Rct. # 12B98 ; he CASH .) 5hh /1P2
Contractor: 2I!L ' Address: ?ems Phone: 6
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 IITCD 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:
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