HomeMy WebLinkAboutBLD Sewer Adequacy - 7/6/2023 400500
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Application for Determination of Sewer Adequacy
Instructions:
1,Complete Pan 1 of application. Permit number may be added at 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 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 Data 7/6/2023
Mailing Address: 33455 6th Ave S,Unit I-B Ohy,State,21p: Federal Way,WA,98003
Site Address: 300 NE Olympic Ridge phone. (253)2%-1322
Parcel Number: 12328-51-00057 Permit Number. 9u K> G2q -6Qi 1967
Part 2:Sewer System Information
Name of Sawa System: &16ir 9 Site Plan attached?
018e1al use onty: Sewer System Manager"Des/grated Employee ISM complete.
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Must meet ail Mason County design and construction standards must pay all fees
including:connection fee vAth pamut and inspection inspectionjae,and Latecomers charge CTBD .
Richard Dickinson r/1323
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Part 33- Mason County Public Health Review/Approval
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The form may be scanned and available for public view on the Mason County web Site.
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