HomeMy WebLinkAboutBLD Sewer Adequacy - 11/7/2023 • �'�:40N1�1ENTAL
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MASON COUNTY aHEUON: 6Mnano,F%T.400
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Application for Determination of Sewer Adequacy
Incwctions:
1.Complete Part 1 of application. Permit number may W added at later date.
2.Take application,Site plan,and any other associated inhxmation with the proposed development to the Sewer
System Manager or Designated Employee for approval.
3.Submit completed application and infoonation to Permit Canter or Mason County Public Health for review.
NOTE:You must supply the System Manager with a she plan for the proJsct,showing all existing or proposed
sower components and lines In relation to proposed development and property.
Part 1:Applicant Parcel Information
Applicant Lauren Fafnis,Agent for Lennar Northwest,Inc Date: 1 1/712 02 3
Mailing Address: 33455 6th Ave S,Unit 1-B city,State,2p: Federal Way,WA,98003
Site Address: 131 NE Belfair Station Phase, W3lwa,,.//ojJss..,,ss� ,/7 //y�y�yy
Parcel Number. MJ 51-0e127 Permit Number: ft 0 00 -00113
Part 2: Sewer System Information
Nams of Sewer System: &Mor She Plan attatlwtll
Omelet use only: Sawar System Masseser or Ooslgnabd Employee is to couplers.
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Meem Cwnly Peers.
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Must meet all Mason County design and construction standards,must pay all fees
including:connection fee with permit and inspection fee, tecomers charge
Richard Dickinson 11/923
PMe1Me,�d3wlem Mega/Empbree Blewuetlepb Msiysl Fnpbrw aY
Part
✓3:Mason County Public Health Review/Approval C `A
efsfeclory ❑ 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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