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HomeMy WebLinkAboutWAT2023-00078 - WAT Application - 4/19/2023 4/18/23, 12:48 PM Yahoo Mail-No Subject • t l i MASON COUNTY COMMUNITY SERVICES 19iMring RMrva+u l..r�awr+.�+wt I4*diI ...Ili a Nr►f.ehh 415 N 8 Street.Bldg 8,Shelton WA 08594, I v E D Shelton (360y 427.9670 ext 400 a Birllair (360)275.446r©xi 400 <� Elma (360)482 FAX(360)427.7787 Application for Determination of Water Adequacy APR 19 2023 Instructions _ 615 \N Alder Street 1 Complete Pert 1. No determination can be made until Part 1 is Julie comolete 2 Complete only the portion of Part 2 applying to the type of water connection utilized. 3 Submit completed application,with any required attachments for review 4 An approved building site plan must accompany this application. Part 1: Applicant/ Parcel Identification Name on Applicant Corbin & Abigail Craig Date, 4/27/21 Mailing Address: P.O. Box 741 Union, WA 9859ahone. (360)490-7096 Parcel Number: 32106-75-90162 Type of Water System Reason for Application 141' Public/Community Water System (2 or more Building permit CJ Ld ab3-- 00/-13/-1 connections} CI Division of lane. O Individual water source(one connection), #of Parcels" SPL O Well 0 Boundary line adjustment --� o Spring/surface water 0 Other(explain)_— ❑ Other(explain)_— --- 0 Replacement or Remodel(please indicate name It you have more than one residence connected of water system below if applicable-no to this well.check the Pubic/Community Water signature required) System box Part 2: Water Connection Information APPROVED Complete the section appropriate for the type of water connection being evaluated JUN 08 2023 Public Water System MASON COUNTY E`IVIRONMENTAL HEALTH Name of Water System Union Ridge RET Water Facility Inventory(WFI)Number 06553V (write-none' for two-party) 6e I am the manager of this water system. The water system has been approved for 52 services There are presently 40 connection(s)in use This will be the 41 connection. 0 I am the manager of this system. This connection will be to upgrade or change the use of an existing connection on this system(i e. recreational to full time). Please indicate on the following line the nature of this change.This water system is able and willing to provide water to this(these)connection(s)without exceeding the limits of the water system or any limits set by state and local regulation. Signature of Water System Manager _ Date 0422/2021 This form may be scanned and available for public view at www.co.mason.wa,us. J A lI Fornix thini.rr. ,ti;,:y kc w 1 I:2 26;s ...,:'t :s!'$.n'Ss.::,nei`.?:..."sM .s;»ft,i,t ..p,N.-4z4tI Et!144K{#t:721 .ttli'fiti • . - `6500 V3-W43T 4110 ; ,.-.r;. about:blank 2/4