HomeMy WebLinkAboutBLD Sewer Adequacy - 7/25/2023 400511
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COMMUNITY SERVICES E12dA0 82-5269,EXL 400
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Application for Determination of Sewer Adequacy
Irmuuctions:
1.Complete Part 1 of applcation. Perri 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 Manager or Designated Employee for approval.
3.Submit completed application and information to Penult Center or Mason County Public Health(or levies.
NOTE:You Most Supply the system Manager with a site plan for the project,showing all existing or proposed
sewer components and lines in relation to proposed development and property.
Part 1:Applicant I Parcel Information
Appikant Sam Martin Agent for Lennar Northwest,Inc Data 7/25/2023
Mailing Address: 33455 6th Ave S,Unit I-B city,stare,zip: Federal Way WA 98003
Site Addroaa: 260 NE Ohm*Ridge
Phone: (253)29,1-1322
Parcel Number 12328-51-80a53 Peril Number. pit Dl7()a4— OO166
Part 2: Sewer System Information iJ��..rr Site Plan attached?
Name of Sewer system: ergav
FL
only, Sewer System Manageror Designated Employee is to complete.
letlM: Iheve nviev:M Me aplicanis xLL
rony PemMeanlCouny Pemit tlx aPPxr+n.le+.eHwaPFa.'^s MfwmetioneM Mytlaana/NOT evaMble b this papay
ro Me bNm'xmma amle-w an aw wn.atl�am meet all Mason Coun desi n and construction standards must a all fees
ding: connection fee with permit and inspection fee,a atecomers charge(TBD).
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Part
33:Mason County Public Health Review/Approver (�.., �c /6(iy
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This form maybe sunned and available for public view on the Mason County web Site. '