HomeMy WebLinkAboutBLD Sewer Adequacy - 4/25/2023 400453
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Pad 1 of application. Permit number may he added at later date.
2.Take application,Site plan,and any other associated inbrmatlon with the proposed development to the Sewer
System Manager or Designated Employee for approval.
3.Submit completed amilcation and Imormm on to Permit Center or Mason County Public Health for review.
NOTE:You must supply the System Manager with a site plan for the project,showing all existing or proposed
sewer components and fines In relation W proposed development and property.
Part 1:Applicant/Parcel Information
Applicant Sam Martin,Agera for Lennar Northwest,Inc Date: 4/25/2023
MailinpA&IMS: 3315561h Aw S.Urh1-B,Federd Way,98CO3 city,Slate,lip: Federal Way,WA,98003
Site Address: no Ne RdWr6lelbn Phone: (u3)291-131x
Parcel Number. 1U28 51-00012 Permit Number.31d = -oma5
Part 2: Sewer System Information
Name of Sewer System: Belfair ® Site Plan anal
Official use only: Sewer System aW1Mga or Design marl 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 finspectipQfee,and Latecomers charge TBD .
Richard Dickinson —_ SM3
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Part 3:Mason County Public Health Review/Approval
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Satisfactory ❑ Unsatisfactory �1,`�a� �p1 aaA t 1
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This form may be scanned and available for public view on the Mason County Web Site.
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