HomeMy WebLinkAboutBLD Sewer Adequacy - 6/16/2023 400469
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Pan t of application. Permit number may be added at later data
2.Take applicaton,Site plan,and any other associated information vath the proposed development to the Sewer
Systam Manager or Designated Employee for approval.
3.Sulund 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 prolaid,showing all existing or proposed
sewer components and lines In relation to proposed development and property.
Part 1:Applicant/Parcel Information
ApplfoaM Sam.Martin,Agent for Lennar Northwest,Inc Data: 6/16/2023
Mailing Address: 334556th Ave S,Unit 1-B City,State,zip: Federal Way,WA,98003
Site Address: 81NERidgetoo Crossing phone: (Bn2el-1322
Parml Number: 12328-51-00025 PermltNunber. ` 24-0on4
Part 2:Sewer System Information '..
Name of Sewer System: aelhh g Sge Plan*laded?
onkt use only: Sewer System Manager ar Designated Employee fs M complete.
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Must meet all Mason County design and construction standards must pay all fees
including:connection fee with pennd and inspection fee,and Latecomers charge(TBD).
Richard Dickinson 52923
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Part�:Mason County Public Health Reviewl Approval
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This form may be scanned and available for public vlew on the Meson County Web Site.
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