HomeMy WebLinkAboutBLD Sewer Adequacy - 8/23/2023 . yoo5y3
415 N.eTH STREET,SLOG a MELTON NM.541
MASON COUNTY aH0.TON:3001PA8)e EXT.Wo
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Application for Determination of Sewer Adequacy
Instructions:
i.Complete Pan i of application. Permit number may be added at later data.
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 is Applicant/Parcel Information
Applicant Sam Maim,Agent for Iennar Northwest,Inc Dale: 8MI2023
Mailing Address: 33455 6th Ave S,Unit I-B city,state,zip: Federal Way,WA,98W3
Site Address: 1511,0101ympk Ridge Phone: (253)M1-13n
Parcel Number. I23M-51-00082 Permit Number. JLD
Part 2:Sewer System Information
Name of Sewer System: selfur ®. Site Plan attached?
official use only. Sewer System Manager or Designated Employee is to complete.
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Must meet all Mason County design and construction standards, must pay all fees including:
WPwrineclion
fee with permit and inspection fee,and latecomers charge(TBD)
0— 2s73
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Part 3: Mason County Public Health Reviewl Approval Q 1 u IZ3�Z�
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This form may be scanned and available for public view on the Mason County Web Site.
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