HomeMy WebLinkAboutBLD Sewer Adequacy - 7/25/2023 400512
415 N.BTH STREET,BWG S.SHELTON WA M.
MASON COUNTY SHELTON: 6¢1 96 O,EXT.and
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Part 1 of application. Perms number may be added at later dale.
2.Take application,Site plan,and any other associated infornonon with the proposed development to the Sewer
System Manager or Designated Employee far 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 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: 7/25/2023
Mailing Address: 33455 6th Ave S,Unit I-B city,State,zip: Federal Way,WA,98003
Site Address: 270 NEdympic RHl9C phone: (353)29 IN2
Parcel Number, 12 32 6-51-00 05 4 Permit Number, fU 02!�-oni:IS
Part 2:Sewer System Information
Name of Sewer System: Bebdr Ej Site Plan attached?
officialMny: Sewer System Managwor Designated Employee is to complete.mwlloN IM1aw retie.veEounty PermBonnxlim: IM1ays revie n,Meson Cmao,Pamnrivxtl tie epaxands Nbrmalim and nod ,,dmaadC sewer wnneclun n avranxf NOT avaWda b VAN propaMM Me fdWvhg coM4im(a)m aM ConeanoMYq Masan CwMY PeiMt(cplrorlelJ met II Maso County design and construction standards must pay all fees _
into in :coogcj n fee with it and inlipiclign a
Richard Dickinson
8/423
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Part 3:Mason County Public Health Review/Approval< 7,/13 f� Lf
Satisfactory ❑ Unsatisfactory
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This form may be scanned and available for public view on the Mason County Web Site.
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