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Home My WebLink AboutBLD Sewer Adequacy - 3/7/2023 NSON COUty Public ' Health Always working for a sa`er healthier Mason County 415 N.6th Street,Bldg 8,Shelton WA 98584 360-427-9670 or 360-275-4467,extension 400 Application for Determination of Sewer Adequacy Instructions: 1.Complete Part 1 of application. Permit 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 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 lines in relation to proposed development and property. O` rO 5CUn , eirfcir7 letter.' eie 5 r/i.eibreepe,/7et Part 1:Applicant/Parcel Information Applicant: .4;1 C S C o J'//0/77k S C- 2 Date:( "3` O 7 3 Mailing Address: PO SC'X 53e) City,State,Zip: Jewel Cf' -/e kk .'.Y.36f3 Site Address: Phone: 360 6,2 6/- 6.) Parcel Number: /ZZ -23-960// (ior4 ) Permit Number: Part 2: Sewer System Information Name of Sewer System: y�� i2. Lu�� -We t Site Plan attached? Official use only: Sewer System Manager or Designated Employee is to complete. • New Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ Existing Connection. I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ I have reviewed the applicants information and have determined sewer connection is currently NOT available to this property. 43, Ple,T add the following condition(s)on the corresponding Mason ounty Permit:(optional) 1 // / r .SIR /r Z.4 rl l�TirLAYI r�� '�/J .FL�lilnl-t"��vL /,S • �U ram/h/f teyN .�La7` ✓F .S L ` �/J /` 1-1 mu / CUgl�/b//4s / /l�G�STQtG (A /v.Z/!/.eic '3/ l/ G� �--5 • t r, 1 I/CVc-rc"4s , v�-tomZ3 4 Printed Name of System Manager!Employee Signature of System Manager!Employee Date Part 3: Mason County Public Health Review/Approval ❑ Satisfactory ❑ Unsatisfactory Signature of Environmental Health Specialist Date This form may be scanned and available for public view on the Mason County Web Site. REVISED 1c7e2015 ARSON CO U�r1, Public Health Always working for a safer i healthier Mason County 415 N.6th Street,Bldg 8,Shelton WA 98584 360-427-9670 or 360-275-4467,extension 400 Application for Determination of Sewer Adequacy Instructions: 1.Complete Part 1 of application. Permit 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 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 lines in relation to proposed development and property. 0K 7-0 SCari ; el71a,7 /e/teie.• cies@6Q•�brfc' /7e7- Part 1:Applicant/Parcel Information Applicant: 7--I C S CD ti ✓//0l-771-.5 //V G Date: -3.3- 2U, /�O ,SOX 930 /ve / � '3cf� Mailing Address: X City,State,Zip: J� i C/G e wQ Site Address: q (o1 ) Phone: AGOtZParcel Number: 23-9o// Permit Number: Part 2: Sewer System Information Name of Sewer System: ❑ Site Plan attached? Official use only: Sewer System Manager or Designated Employee is to complete. 12 New Connection. I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ Existing Connection: I have reviewed the applicants information and have no issues with Mason County Public Health approving the corresponding Mason County Permit. ❑ I have reviewed the applicants information and have determined sewer connection is currently NOT available to this property. //�• PPlease add the following condition(s)on the co espondiinng Mason County Permit:(optional) ,GJ�� ///�/ft,o k L� .SgaL-�rL A., /malty Iw��G• 7- .St?/G`� !/i'/DG i i � r`Z 4 Printed Name of System Manager/Employee Signature of System Manager/Employee fete 7 Part 3: Mason County Public Health Review/Approval ❑ Satisfactory ❑ Unsatisfactory Signature of Environmental Health Specialist Date This form may be scanned and available for public view on the Mason County Web Site. REASEO Ia2f.20 5 I ( 1J9 66 �'#,f • February 21, 2023 RE:Water Adequacy for parcel#123282390011, lots A, B, C. Water Adequacy for Lots A and C Belfair Water District will be the water service utility provider for this project. The District believes there to be adequate water to supply this development, at such time as the plans have been reviewed and corrected to meet Belfair Water Districts standards and specification, and the project aligns with the Districts approved Water System Comprehensive Plan, and all development fees and connection fees are paid as required by the Districts Developer Extension Agreement. A Water Adequacy will be signed and submitted for Mason County review with the understanding that the above statement will occur before development will occur, and all Plans will be final and agreed upon and all fees paid confirming commitment. The District currently has capacity to supply this connection based on Available ERU's, and as such is allocating the requested 2 connections needed for this development as a preliminary allocation. The District retains the right to withdraw this commitment if progress, planning and development has not moved forward in the next 24 months(2 years). All Current remaining connections are on a first come first serve basis. The cost for these 2 water adequacies will be$500.00 each, once payment is received the water adequacy will be signed and sent back for forwarding to Mason County. As mentioned prior this adequacy will stay with the property, if development and connection is begun or completed within the 24 month period then a credit of$500.00 will be taken from the fees associated with the connection to the developed lot or lots. Please contact us with any questions you may have at 360-275-3008 Mon-Friday 8:00am to 4:00pm. Or contact me directly via email at dwebb.bwd@hcc.net. Thank you, Dale Webb General Manager Belfair Water District#1