HomeMy WebLinkAboutBLD2023-00484 Lot 8 - BLD Sewer Adequacy - 2/9/2023 Acct#400426
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Application for Determination of Sewer Adequacy
Instructions:
1.Compete Pad I of application. Permit number may be added at later data
2.Take application,SRa plan,and any other associated Information with the proposed development to the Sewer
System Manager w Designated Employee for approval.
3.Submit completed application and Information to Permit Center or Mason County Public Health for review.
NOTE:you most supply the System Manager with a site plan for the project,showing all existing or proposed
sewer compona nes and lines In relation to proposed development and property.
Part 1:Applicant I Parcel Information
Applicant Sam Martin,Agmt for Lennar Northwest,Inc Date: 02/09/2023
Malling address: 33455 6th Ave S,Unit 1-B airy,Safe,zip: Federal Way,WA,98003
SIIe Addreas: IMNEWdr Eation*Mdranwblwrochmse Phame: 0531N4-1322
Panel Number. ID28.23d IBU-24-NM Went parody Pernit Number �Ir� G.f.JZ��Qd
Part 2:Sewer System Information Lo ` 8
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Must meet all Mason County design and wnstructlon standards,must pay all fees including:
Y f with aEnd in,pedian fee sad 'N rorr)•arx charge(IBD)
Richard L.Dickinson .--F� _---�--— 2/1323
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P Mason County Public Health Revievrf Approval S
■7 atiefaUory ❑ Unsatisfactory
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This form may be scanned and available for public view on the Mason County Web Site. --