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HomeMy WebLinkAboutBLD2022-00885 - BLD Sewer Adequacy - 4/27/2022 415 N.eTH STREET,BLDG B,SHELTON WA M504 SHELTON:35odP-OB70.EXT 400 MASON COUNTY COMMUNITY SERVICES BE 5LNj ELMA,39o344 7S67,EXT.400 3Bp4e3528e,FXT.4W BuAdngu Nanaln%FnWmnmental Hold,continually Health FM.380427-P90 Application for Determination of Sewer Adequacy Instructions: 1.Complete Part 1 of application. Pennit number may be added at later date. 2.Take application,Site plan,and any other associated information with the proposed development to the Sewer System Manager or Designated Employee for approval. 3.Submit completed application and infonnallon to Permit Center or Mason County Public Health for review. NOTE:You must supply the System Manager with a site plan for the project,showing all existing or proposed sewer components and tines In relation to proposed development and property. Part 1:Applicant I Parcel Information Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 4/27/2022 Mailing Address: 33455 6th Ave S,Unit 1-B city,State,zip: Federal Way,WA,98003 Site Address: WHC HS 142 Address TBD Phone: (u3)29a13222 ffaa Parcel Number: 12328-21-00000;12328-u-00000,areat plods Permit Number. 3J L/VZC)-&2— V Part 2: Sewer System Information Name of Sewer System: Cb A"f El Site Plan attached? official use only: Sewer System Manager of Designated Employee is to Complete. r91 New ConneNarr. Ihaw owiexeE the epDli®Msl thrmason and hava no loose with Mason County Public Heath appicong to comersntlinp Masan County Penit ❑ ealsling Connection: Ihwe missed the aWlcants lntomosch,arv3have no Issues will,Macon County Public Health appmrbg the correspondhg Mason County Permit. ❑ I have rovlerved the ii,simnt,lnot—Von antl have demrmined sonar wnnactlon is currently NOT aveileda b this property. Funse add the ,owhp cagdknla)u,Has co—poodle,,Mason coaho Permll:foprbnap r' iu om ClW 4ay5 ftaiahr r I 1,llo 14 b 54 A 1 A �e zodtDn P 1.y 4,mu roc titCFC cLfaacs. or up 1 -6w On 5,ra6 Pia LL— — prMNNemed3pumManger/Empkyes 31 Wed Bytom Mmyedenne a DMe Pa�rt3: Mason County Public Health Revile Approval 1 ( abstactory ❑ Unsatisfactory VV S_ Signatured EnNmm``nnrp�eMdelH Ilhspwlal't Deb `1\Il� This form may be scanned and available for public view on the Mason County Web Site, oc_hascvayen