HomeMy WebLinkAboutBLD Sewer Adequacy 400505
415 N.WTH STREET,BLDO B.SHELTON M985e4
MASON COUNTY SHELTON'O¢p vwo,Exr gee
COMMUNITY SERVICES �soa 38043c "T'M4.
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Application for Determination of Sewer Adequacy
Instructions:
1,Complete Pad I of application. Permit number may be added at laterdate.
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 fa 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(o proposed development and property.
Part 1:Applicant I Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Data 7/6/2023
Mailing Address: 33455 6th Ave S,Unit 1-B City,Stale,Zip: Federal Way,WA,98003
Site Address 301 NE Olympic Ridge Phone: 129I294-1322
Parcel Number. 123 28-5 1-000 72 Permit Number
Part 2:Sewer System Information r-t
Nameof Sewer System: BelEair 9 site Plan anocied?
Olfiyc(al use only Sewer System ManoW or De ignited Employee Is w complete.
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Must meet all Mason County design and construction standards, must pay all fees
including:connection fee with permit and inspection f and Latecomers charge
Richard Dickinson 7/1323
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Par[3: Mason County Public Health Review/Approval
absfactory ❑ Unsatisfactory
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This form may be scanned and waltable for public view on the Mason County web site. (�y�
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