HomeMy WebLinkAboutBLD2023-00493 - BLD Sewer Adequacy - 2/9/2023 Acct#400421
415 N.erH STREET.BIDO a,SHELTON MOM
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete an 1 of application. Pemil number may be added at later dale.
2,Take appliOthm,Site plan,and any other associated information with the proposed development to the Sam,
System Manager or Designated Employee for approval.
3.Submit completed application and information 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 line in relation TO proposed development and property.
Part 1:Applicant I Pamei Information
Applicant Sara Martin,Agent for Lennar Northwest,Inc Data. 02/09/2023
Meiling Addmss: 33455 6th Ave S,Unit I-B city,Stara zip: Federal Way,WA,98003.
Sine Address: IW NEadfelr5aeon•Addmuubial to chase• Phone: (253)291-1322
Pamei Numbe, Pemllt NlmbBr. -4�VjZA23-
Pert 2:Sewer System Information �I L1h�jJ�,lc- _
Name of skewer System: Mover `-4 • •la50 ® Site Plan stlechetl'!
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et all Mason County design and construction standards,must pay all fees including:
soli fee with Derma andinspection fee,and Latacome chard (TBD)
Richard L.Dickinson 2/13/23
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P 3:Mason County Public Health Review/Approval
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This form may be scanned and available for public view on the Mason County Web Site.