HomeMy WebLinkAboutBLD Sewer Adequacy - 5/15/2023 40I 161
MASON COD-jV Public Health
Always working for a safer healthier Mason County
415 N.BIh Seat,Bldg 8,Shafon WA al
3 2T-96T0 or 380-2I54487,extension 400
Application for Determination of Sewer Adequacy
InstrucBona:
1.Complete Part 1 of application. Permit number may be added at later data
2.Take application,Site plan,and any other associated information with the proposed development to the Sewer
System Manageror Designated Employee for approval.
3.Submit 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 project,showing all existing or proposed
sewer components and lines In relation W proposed development and property.
Part 1:Applicant I Parcel Inform ation
Applicant Sam Martin,Agent for Lennar Normest Dare: 5/15t23
Mailing Address: 33455 6th Ave S,Unit 1-B City,State,Zip: Federal Way,WA N003
Silo Aches: 160NERidgetop Crossing Phone: 253-2W322
Parcel Number. 12328-51-111 4DM I7 Permit Number
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Part 2: Sewer System Informa W tion +e rl
Name of Sewer System: Begair Sealer District ® Slte Plan amiched7
OM�c/ialuseonly: Sewer System ManagerwDwigrutodEmploywmWc=Wfste.
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Must meet all Mason County design and construction standards, must pay all fees
including:connection fee with permit and inspect' ,and Latecomers charge(TBD).
Richard Dickinson 5123123
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Part 3: Mason County Public Health Review)Approval
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This form maybe scanned and available for public view on the Mason Courtly Web Sim.