HomeMy WebLinkAboutBLD Sewer Adequacy - 6/16/2023 400485
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Application for Determination of Sewer Adequacy
Inabucaons:
1.Complete Pan 1 of epplicafiW. Permit number maybe added at laterdate.
2.Take application,Site plan,and any other associated information with the proposed development to the Sewer
System Manager or Designated EmplN'ee for approval.
3.Submit completed application and Information b Permit Center or Mason County Public Health for review.
NOTE:you must supply the System Manager with a star plan for the proJact,showing all existing or proposed
sewer components and lines In rotation b proposed development and property.
Part 1:Applicant I Parcel Information
Applicant: Sam Martin,Agent for Lennar Northwest,Inc Dare: 6/16/2023
Mailing Address: 33455 6th Ave S,Unit i-B city.State,zip: Federal Way,WA,98003
Site Address: a?m NF0tWp' Rt Phone: (251)n 1311
Parcel Number 12328-51-00063 Permit Number )
Part 2:Sewer System Information
Name of Sewer System: Bd"r g Site Plan attached?
OMelalmeonly: Sawer Syafam Manager or Designed Employes la to tnmplea.
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Maven Cwnry PermlL
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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 Latecomers charge(Tout.
Richard Dickinson W9/23
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part3:Mason County Public Health Review/Approval I. I21� L
~IF('y Satisfactory ElUnsatisfactory er ao Noun so-see
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This form may be scanned and secilable for public view on the Mason County Web Sib.
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