Loading...
HomeMy WebLinkAboutBLD Sewer Adequacy - 5/15/2023 400478 �RgON COONT Public Health Always working for a safer healthier Mason County 415 N.am Sealed,Bldg 8,Shelton WA 985M 360-427-9670 or 66P275"Isr,ealansbn 400 Application for Determination of Sewer Adequacy Instructions: 1.Complete an 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 Manager or 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 art,plan for the project,showing all exlsling or proposed sewer components and lines In relation to proposed development and property. Part 1:Applicant/Parcel Information Applicant: Sam Martin,Agent for Lennar Nonhest Dam. 5115/23 Mailing Address: 33455 6th Ave S,Unit 1-13 City,Stet,,Zip: Federal Way,WA 98003 Site Address: 271 NE Belfair Station Phone: 263-2944.-11322 Parcel Number: 12328S1-OD037 Permit Number: Part 2: Sewer System Information Name of Sewer System: Belfair Sewer District ® Site Plan attached? Official use only: Sewer System Manager or Designated Employee Is M complete. ® NewCmneWen laew rwiewetl Na epplirsnb Nramellan eM Neva roiawnvdN Mebn CeuMy Public lleelN epprovi,q the wneepagY,g Meson county Front. ❑ E abr,,Corms m I have revlewed he aWls"rib inlaTMbn and have no lwueswiN Meam Cwnry PulAo Health appwin'an cmresgatllna Mason County Parma. ❑ I haws nadexad ow apMkants lnexrnatlm and have debrMmd sewer mnnecion Is wrmney No'available b ads prt,tedy. ® PMaae add Na(dhvfip wmnpn(sl anthacwreepa,ditq Meson County Pomlll:(opaone9 Must meet all Mason County design and construction standards, must pay all fees including: connection fee with permit and inspection fee and Latecomers charge(TBD). Richard Dickinson 6/12n0 P,wM theme NSyaanMwylEmpMryss BgMvadEynen W,pe,/Erigblas Mla Part 3: Mason County Public Health Review/Approval Satisfactory ❑ Unsatisfactory al9nMun of EnWonmenN nll1 NSpedells This form may be scanned and available for public view on'the r`Mason County Web Site.