HomeMy WebLinkAboutBLD Sewer Adequacy - 4/25/2023 400448
415 N.aTH STREET,KD3 q SHELTON wA WSea
MASON COUNTY aHELTON;ass 27s,SeOe EAT.40e
COMMUNITY SERVICES aELFAIR:Waa - ml.EXT.4.
EIMA:BBa-4a23269.EXT.4oa
OUIIOi,g,Phnnlrg EmYonmenlHNnllRremmunlly l'ea11A FAX.a 4]1-]]9e
Application for Determination of Sewer Adequacy
InelrnLtl0a5:
1.Complete Pan i of application. Permit number may be added al later date.
2.Take application,Site plan,and any other associated information with the proposed development to the Sewer
System Manager or Designatetl Employee for approval.
3.Submit completed application and information to Permit Canter or Mason County Public Health tar review.
NOTE:you must supply the System Manager with a site plan for the project,showing all Totaling or proposed
sewer components and Ilnes In relation to proposed development and property.
Part 1:Applicant/Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 4/25/2023
Mailing Address:334555rh Ave S,Unit I,FMnd Way.99003 City,Slate,zip: Federal Way WA 98003
Ste Address: l 4n NE BeI--.— Phone (l9)39 I", p/
Parcal Number: 13328-51-Eii Permit Number l�l/) q/ y3. o U
Part 2: Sewer System Information
Name of Sewer System: aelBir Site Plan attached?
E
ci. Sewer System Manager or Designated Employee is M complete.nn lbn: I Nva revbveG wn,Pamol.can.— IMVe rwleweG he aPMkenbFraaraGPn and haw re E.—eth Memn Conk PlMk HWIM eppm"a vecMaq M+wn GoanN ParrNwW IAe OGNicarNOlnlaNbProrary xM Ne rolbwinO conchions)°n tlN--v,Xeln9 Mown Cwmy Pmmt 1g "
meet all Mason Coun desi n and construction standards must a all feesding:connection fee with permit and inspection fee,and Latecomers charge(TED).
_ _ . 514123
chartl Dickinson I N.q Mswm^Aw,wwl Emlaw. aq
d sva.n M.wwlu�lrow• °Ye
Pa q 7:Mason County Public Health Reviewl Approval
Mason
❑ UnsatisfacAay sgramredemk 1elH.un sPedn •w
This form maybe scanned and avallabls for public view on the Mason County Web Site. rise.