HomeMy WebLinkAboutBLD2022-00862 Lot 124 - BLD Sewer Adequacy - 2/9/2023 Acct#400424
015 N.Vil ETNEET,W.DO 8,SHELTON WA91584
MASON COUNTY SHELTON;a 219670.EXT.4w
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Application for Determination of Sewer Adequacy
Instructions;
1.Complate Pad 1 of application. Permit number may be added at later data
2 Take application,Site plan,and any other associated Information with the proposed development to the Sewer
System Manager or Dasignslad Ennployee for approval.
3.Submit completed application and Information to Permit Center or Mason County Public Hull for review.
NOTE:You must supply the System Manager with a slle plan for the project,showing all existing or proposed
sewer components and lines In relation to proposed development and property.
Part 1:Applicant I Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 02/09/2023
Noting Address: 33455 6th Ave S,Unit I-B City,State,Zip'. Federal Way,WA,98003
Site Address: 1nINEaelrair Shann•Addw.a.btmttochmgd Phone: 115 31 394-13 2 2
Parcel Number: Mll 21,08088i Permit Number: 61d 2�022 � OO SLO a
Part 2: Sewer System Information Lo+' 12'4
Nameolsawar System: &Ifdr ® Site Plan attached?
OlHclatunuonly: Sewer System Manapror Designated Employeeisfocomplefe.
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Meow,Coun1Y Pane.
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Must meet all Mason County design and construction standards.must pay all fees including:
connector,fee with permit and inspection fee,and Latecomers charge(TSD).
Richard L Dickinson 2/13/23
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Part
33::Mason County Public Health Review/Approval
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This form may be scanned and available for public vlev,on the Mason Count\ty Web-`Site.
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