HomeMy WebLinkAboutBLD Sewer Adequacy - 8/11/2023 400535
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MASON COUNTY
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Application for Determination of Sewer Adequacy
Instructions:
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Padi of application. Permit number may be added at later dater sed Bevel ment to the Sewerication,See plan,and any other associated information with the p opo opager or Oesignaled Employee for approval
mpleted application and information to Peril Center or Mason County Public Health for reviewro osetl
must supply the Syslem Manager with a site plan for the project,showing all existing or p Dponents and lines In relation m proposed development and property.
Part t:Applicant I Parcel Information
Applicant Sam Martin,Agent for Lcnnar Northwest,Inc Dam: 8/11/2023
Mailing Addmss: 33455 6th Ave S,Unit 1-B city,Slate,zip: Federal Way,WA 98003
91 NE nlympk Rider Phwrx (03)2%-L322
Site Address: ,rjl y�^M'l —ne.,.1-1 rT
'. Parcel Number. 22ne3t-0W29 H3 aN Peril Number. lN'YIA-
Part 2:Sewer System Information
Name of Sewer System:
&1 it La1 Site Plan ageched?
DMclel use only: Sewer;;�Richard
anageror Designated EMPIOYee is w complete.
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ElMe .adsurtap .u.awre..wr'a wwn cwvy Must meet all County design and construction standards, must pay all fees
inCludin fee with nnit and ins ction fee and Latecomers cha aRichard Dickinson 8115/23
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Pa1rtt33:Mason County Public Health Reviewf Approval
Satisfactory ❑ Unsatisfactory ysnwrsdenP ^ tle1m
/yJ This form maybe scanned and available for public view on the Mason Country Web Sita. fir