HomeMy WebLinkAboutBLD Sewer Adequacy - 8/23/2023 i
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Part 1 of application. Permit number maybe added at later date.
2.Take application,Side Wan,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 1 Parcel Information
Applicant: Sam Martin,Agent for Lennar Northwest,Inc Date: 8/23/2023
Mailing Address: 33455 6th Ave S,Unit 1-B city,State,zip: Federal Way WA 98003
161 NE Kaki Phone: (253)294-1322
Site Address: �rrnv" xs /�T�
Parcel Number. into 51-B0066 Permit Number. �t-D m����
Part 2: Sewer System Information
Name of Sewer System: adeal ® Site Plan attadleV
official use only, Sewer System Mamgoror Designated Employoe is to co7NOP".
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wnaelaa6Vq Mawn county Pame.a,aaP0.r0alM,a.r nand tu-delarrrimdaewerwnmr2cn is wneM N NOP"P"..rdlowhe wndslwNal-me wemsw "W MawnewMy Pa,nil faPlNVM9Must meet all Mason County design and construction standarll fees including:
connection fee AO permit and inspection fee,and latecomers charge(TBD)
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Pai�?: Mason County Pubic Health Review/Approval
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This form may be scanned and available for public view on the Meson County Web Site.
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