HomeMy WebLinkAboutBLD Sewer Adequacy - 11/7/2023 400472
415 N.arli STPEET.KDG 9,SHELTON Wsal
MASON COUNTY SHELTON:390-427.99m,E%L 4W
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Application for Determination of Sewer Adequacy
instructions:
1.Complate Pad 1 of application. Permit number may be added at later date.
2.Take application,Site plan,add any other associated Information with the proposed development to the Sewer
System Manager or Designated Employee fa approval.
3.Submit completed application and information to Permit Center or Mason County Public Health for review.
NOTE:You meet supply the System Manager with a she plan for the protect showing all existing or proposed
sewer components and lines in raladon to proposed development and properly.
Part 1:Applicant/Parcel Information
Applicant Lauren Fafnis,Agent for Lennar Northwest,Inc Date: I1/7/2023
Mailing Address: 33455 6th Ave S,Unit I-B City.State,zip: Federal Way,WA,98003
S;le Address.310 NE Belfair Station phone: (u3)3084265
Parcel Number. niazfl.s-olwzfl Permit Number. F;Lh&10 I4-002;21
Part 2:Sewer System Information
�'�, Name of Sewer System: aclrmr [Lz( Site Plan attachetl9
OMctal use Doty: Sewer System Manager or Designated Employee is to Complete.
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Must meet all Mason County design and construction standards, must pay all fees
including:connection fee with permit and inspection(fa/es,and Latecomers charge(TBD).
Richard Dickinson 5��—�.G_--,. 1119/23
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Part
3: Mason County Public Health Review/Approval
Satisfactory ❑ Unsatisfactory /C•
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This form may be scanned and available for public view on the Mason County Web Site.
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