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HomeMy WebLinkAboutBLD Sewer Adequacy - 7/6/2023 400502 415 N.M STREET,BOG 9,SKELTON VA.B MASON COUNTY SHELT 3W-U7-W1e M,4W COMMUNITY SERVICES BE "R:eWla,5.44a''cxT'4aa ELMA asoeaasaa,EXT.aoo Wdn¢MannMg,FnvMvnenlalXnNyConvMnMy Beallh Fero% 27�TMI Application for Determination of Sewer Adequacy Instructions: 1.Complete Part 1 of applcation. Permit number may be added at later date. 2.Take application,Site pan,and any other associated information with the proposed development M the Sewer System Manager or Designated Employee for approval. 3.Submit completed application and intonation W Permit Center or Mason County Public Health for review NOTE:your most supply the System Manager with a one plan for the project,showing all existing or proposed sewer components and gees in relation m proposed develops em and property. Part 1:Applicant Parcel Information Applicant Sam Martin,Agent for Lennar Northwest,Inc Dam: 7(6/2023 Mailing Address: 33455 6th Ave S,Unit 1-B City,stem,zip: Federal Way,WA,98003 SMAddirmair 331 NE Olympic Ridge phone: (153)2%-13n Parcel Number. 12328-51-00069 Parrett Number.. Part 2:Sewer System information Name of Sewer System: aeg h l� Site Pion arraGred? Official use only: Sewer System Managavor Oesfgnaced Employee ISM complete. ', [T� New CpinMbrt leave revbwet lM1enePll®n4 MbmallonaM Eee no iuuea vnN Meaen LmMy Pudk HeaaM1 apptMip the mneapaMine '. Macon(:ounbPmmY. ❑ FjlrC�p CmretlLvl; Ilww leJwwa011xapgimNainkvmatim e�ldhm�p gwea HN Memn Gounry Pudk Hed111 eppmr�n9 Na cere"mdka Ma»n County path ❑ Ilwe rovicveE Ne ane—and lMarnaaon xtl Nav,dNvmimE aewerconrcctian mameMa NOT ffVaWoe b are polwly ¢ PlaveaW Vp kamirq wMlYm{a)onlre wneapmdma MasancWyPemC(©lin're// Must meet all Mason County design and construction standards must pay all fees includin :connection fee with 8 and inspection f Latecomers charge TSD . Richard Dickinson 711323 area x.em dsyama wayoree,PkT.e s¢r,.dsym WmaslFryyw Dal. Part 3: Mason County Public Health Review/Approval x n l n^ in t.�—s /2y or's'-ftfacory ❑ Unsatisfactory l -- r `1/ ykvt r' 9a I.V',T/d EMV I elP Spwa'aBY This form may be scanned and available,for public view on the Mason County Web She. ecvaae zxn