HomeMy WebLinkAboutBLD Sewer Adequacy - 7/24/2023 400530
416 N.BTH STREET,SLOG 9,SHELTON M easel
MASON COUNTY SHELTON a60. T-9WB,EM.eW
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Application for Determination of Sewer Adequacy
Instructions:
1,Complete Part 1 of appliraton. Permit number may be added M later date.
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 ar Mason County Public Heaah for rev ew.
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)Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 7/24/2023
Mailing address: 33455 6th Ave S,Unit I-B city,state,Zip: Federal Way WA,98003
Site Address: M1 NE 01,,k aides Phoee: D93)29d-1322
Parcel Number tote"51-0 4 Permit Number. RI Ra.O��f-OOIgS
j Part 2:Sewer System Information
` Name of Sewer System: Bdfw [v] Site Plan attached?
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nly Sower system Manageror Designated Employee Is to complete.
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includin :connecUion fee virith nermili
Richard Dickinson e/4/23
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P;rt 3:Mason County Public Health Review/Approval y� Q dM lg .�/��(4
Satisfactory ❑ Unsatisfactory -�V�
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This form may be sunned and available for public view on the Mason County Web site.
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