HomeMy WebLinkAboutBLD CD Environmental Health Review - 6/16/2023 400495
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Application for Determination of Sewer Adequacy
Instructions:
t.Complete Part 1 of application. Permit number may be added at later date.
2.Take application,Site plan,and any other assocteted information with the proposed development to Vel Sewer
System Manager or Designated Employee for approval.
3.Submit completed application and Information to Permit Center or Mason County Public Heath for review.
NOTE:You must supply the System Manager with a site plan for the project,showing all exlsung or proposed
sewer components and lines in relation to proposed development and property.
Part 1:Applicant I Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Dale: 6/16/2023
Mailing Address: 33455 61h Ave S,Unit 1-B city.State,zip: Federal Way,WA,98003
Site Address: 361 NE Olympic Ridge Phone: (20)IN-13n
Panel Number. 12328-51-00066 Permit Number. F)L 510a*-QnQW
Part 2:Sewer System Information
Name of Swan System aalflr Eg Site Plan attached?
Official use only. Sewer System Manageror Designated Employee is to complete.
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Must meet all Mason County design and construction standards,must pay all fees
including:connection fee with permit and insp2ction fee Anij Latecomers char a BD .
Richard Dickinson 62923
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Part 3'Mason County Public Health Review/Approval �C✓h ` I �( ,
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This form may be scanned and available for public view on this Mason County Web Sue,