HomeMy WebLinkAboutBLD Sewer Adequacy - 8/11/2023 400507
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Application for Determination of Sewer Adequacy
Insauctiona:
i.Complete Pad i of application. Permit number may be added at later date. wer
2.Take application,Site plan,and any other assoouo,d Information with the Proposetl devaloprnenl to the Se
System Manager or Designated Employee for approval.
3.Submit completed application and information ro perm t 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 add lines In relation W proposed development and property.
Pad t:Applicant I Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 8/11/2023
Mailing Address: 33455 6th Ave S,Unit I-B city,state,zip: Federal Way WA 98003
Phone' (253)N4-Il a
$ite Address' ]3a NE Olym ' Ride< 4 A
Parcel Number: Iz31e-st-ooa+9 NSa+9 Permlt Number r11 b2i) 1
Pall 2: Sewer System Information
Name of Sewer System: ad"" ® Site Plan a(tatlrad?
o
fficialowfee
e/Systam Manager or D=M.-�Iau
Employee Is to complete.
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Richard Dickinson 8Ji523
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Pasd,.�3:�Mason County Public Health Review/Approval
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Thb form may be scanned and available for public view on the Mason County Web Site.