HomeMy WebLinkAboutBLD Sewer Adequacy - 7/6/2023 400497
416 N.6TH STREET,KDO 6.SHMON eM93634
MASON COUNTY SHEUON:300 417-r0T0,Wr.400
COMMUNITY SERVICES BEEF 3"2-6269,EXT.4M
E1M4:300.b2-5269,EXT.400
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Part t 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 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 projec4 showing all aMsting or proposed
sewer components and lines in relation b proposed development and properly.
Part 1:Applicant i Parcel Information
Applicant: Sam Martin,Agent for Lennar Northwest.Tnc Date: 7/6/2023
Merin Address: 33455 6th Ave S,Unit I-B city,State,zip: Federal Way,WA,98003
Site Address: 34O NE Olympic Ridge phone: (253)aw-1112 ,tom
Parcel Number. 12328-51-00060 Permit Number..�Q�-o0D45
Part 2:Sewer System Information
Name of Sewer System BNtr She Plan attached?
OMcialuseoMy. Sewer System Manageror Designated Ernployee Is to compete.
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Must meet all Mason County design and construction standards,must pay all fees
including:connection fee with permit and inspection fee,and Latecomers charge ITBD).
Richard Dickinson 711323
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Parj.3: Mason County Public Health Review/Approval ^f
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This form may be scanned and available for public view on the Mason county Yieb Slb.
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