HomeMy WebLinkAboutBLD Sewer Adequacy - 11/7/2023 ' 400471
415 N.GT STREET,BLBG 0,SHELTONWIPBSN
MASON COUNTY SHELiON130A37-w'e tXr'00
COMMUNITY SERVICES B raR:3a6n5aer,EM.4W
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Application for Determination of Sewer Adequacy
Instructions:
J.Complete Part t of application. Permit number may be added at later dale.
2.Take application,Site plan,and any other associated information with the proposed development to me Sewer
System Manager or Designated Employee for approval.
3.Submit completed application and Information b Permit Center or Mason County Public Health for review.
'.. NOTE:you must 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 f Parcel Information
Applicant Lauren Fafnis,Agent for Lennar Northwes4 Inc Date: 11/7/2023
Mailing Address: 33455 6th Ave S,Unit 1-B city,State,zip: Federal Way,WA,98003
Site Address,300 NE Belfair Station phone: (253)306-0265
Parcel Number 3a37a"sl"aoal7 Permlt Number:
Part 2:Sewer System Information
Name of Sewer SYstem: &avf [Y Site Plan attached?
o
fficialoW. Sewer System Manager or Designated Employee is to complete
w.cUq[ Itlaw revIe,va]lM apprra,b'rtlanm4meMFewnbsuveNCpned"cn: IM1aw mvimVL WlwmelslnlmmagYq Masan Lwnb Ra,MLte.'M Ne appbMainbrmaeon antl here delartim meawwma coMlam(e)�^ma w,••vtiva^a Mem 's
t meet all Mason County design and construction standards, must pay all fees
ding:connection fee wRh permit and inspectionfee, and Latecomers charge(TBD).
ard Dickinson11/9/23
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Pa : Mason County Public Health Reviewl Approval
Satisfactory ❑ Unsatisfactory I�=(D ` S ea
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This form may be scanned and available for public view on the Mason County Web Site. G�COI Jan f
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