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COPY <br />Washington State <br />w� Depanr#ment of Transportation <br />Access Connection Permit <br />Managed Access Highways Only <br />Not for use within an Incorporated Citv or Town <br />Name and Address of Applicant <br />Permit IV_UM 6er <br />CP - 61716 <br />KKUtas County Solid waste <br />State Route <br />{Nile Post <br />925 Industrial Way <br />903 <br />3AS Left 0_ Ri_ght <br />Ellensburg, WA 98926 <br />Region <br />County <br />South Central <br />Kittitas <br />Prapeq Address if different from above) <br />Joint Use Connection: Yes No <br />50 Number 5 Mine Road <br />Primary Tax Parcel Number <br />Cie Elum, WA 98922 <br />20-15-21040-0003 <br />Email <br />Additional Tax Parcel Numbers (if applicable) <br />patti.stacey@co.kittitas. wa. us <br />20-15-28000-0013 <br />Telephone <br />509 962-7070 <br />Project Name (If Applicable) <br />Lot # <br />Gov. Lot # <br />Cie Elum Transfer Station Entrance Improvements <br />Average Weekday Vehicle Trip Ends (AWDVTE) not to exceed: 999 <br />Approach width not to exceed 30 feet wide, <br />Public Land Survey System (PLSS) <br />�NE 114 []NW 114 [:]SW 114 F]SE 114 Section 28 Township 20-N Range 15-E <br />Permit Catecip—ry Permit TVDe Current Managed Acoss <br />❑ 1 - Minimum Connection Q Conforming Permi[ Class 1 - 132Y Minimum Approach Spacing <br />m 2 - Minor Connection ❑ Nan -Conforming Permit Class 2 - 664' Minimum Approach Spacing <br />❑ 3 - Major Connection ❑ Variance Permit Class 3 - 3317 Minimum Approach Spacing <br />Class 4 - 2W Minimum Approach Spacing <br />❑ 4 - Temporary Connection <br />Class 5 -125' Minimum Approach Spacing <br />This Access Connection Permit serves: <br />The above -listed parcels with a 30' wide paved joint use approach located at HES 68+15 right, SR 903, Cie Elum <br />to Roslyn, Sheet 2 of 4 Sheets. This permit requires the removal of the approach located at milepost 3.52 right, <br />HES 71+87 right, SR 903, Cie Elum to Roslyn, Sheet 2 of 4 Sheets. <br />The applicant is required to complete Exhibit F - Road Approach Installation Checklist in coordination with <br />WSDOrs Maintenance representative and deliver the completed form to WSDOT's Planning Office. <br />The Applicant herei nafter will be referred to as the "Permit Holder," and the Washington Slate Department of Transportation hereinafter <br />will be referred to as "VHSDOT" WSDOT will allow the Permit Holder to construct, upgrade, use, andlor maintain this access <br />connection provided the Permit Holder accepts all the terms, provisions, and exhibits attached hereto and by this reference <br />made a part of this permit. This permit is assigned to the parcel(s) served by the access connection, and shall remain with the <br />parcels) served by this permit regardless of any change in ownership of the parcei(s). <br />Exhibit A - Special Provisions Exhibit D - Traffic Control Plan <br />Exhibit B -Approach Template & Removal Detail Exhibit E - Easement <br />Exhibit C -Aerial Photo & Right -of --Way Sheet Exhibit F - Road Approach Installation Checklist <br />This permit shall be void unless the work authorized by the permit is started within 90 days of issuance and completed <br />within 120 days of issuance, unless otherwise agreed to in writing by WSDOT or if an extended completion date is <br />listed here by WSDOT. 8131 /2024. No construction work is allowed without a pre -construction conference with WSDOT. <br />Bly signing below the Permit Holder accepts the terms, provisions, and exhibits attached to and made a part of this permit. <br />PERMIT HOLDER <br />WSDOT <br />Print Name <br />Print Name <br />Patti Stacey <br />Paul Gonseth, P.E. <br />Print Title T <br />Print Title <br />Facilities and Waste operations Director <br />Planning Engineer <br />Signature- Date <br />Signature -ate <br />DOT Form 224-005 r r V Page I <br />Revised 1212022 <br />f <br />