HomeMy WebLinkAboutBLD Sewer Adequacy - 4/25/2023 e
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415 N.STH STREET,BLDG a,WELTON NM09584
MASON COUNTY WELTON:39a4n-1970,EM,400
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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 Desgnated Employee for approval.
3.Submit completed application and Information to Permit Center or Mason County Public Health for review.
NOTE:You most supply the System Manager,with a site plan for the project,showing all existing or proposed
sewer core portents and lines In rotation to proposed development and property.
Part 1:Applicant/Parcel Information
Applicant Sent Martin,Agent for Lennar Northwest,Inc Data: 4/25/2023
Mailing Address: 3M556N Aw5 Unit l-a Federal Way 98o03 city,state,Zip: Federal Way,WA,98003
"She Address: Ia1NEjianrsnaon Phone: (3S3)2%-13n nnnnnn
Parcel Number 123U 51-00045 Permit Number ' 6w,-`,�i,/
Part 2:Sewer System Information
Name of Sawer System: BrIho ® Sit.Plan attached?
Oiecaluseonly: Sewer System Manager or Designated Employee is to complete.
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Must meet all Mason Counly design and construction standards must pay all fees
Including:connection fee with permit and ins on and Latecomers charge(TBD).
Richard Dickinson -" --�" 514123
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Part,8: Mason County Public Health Review/Approval
Satisfactory ❑ Unsadsfatlory
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This form may be scanned and available for public view on the Mason County Web Site.