HomeMy WebLinkAboutBLD Sewer Adequacy - 8/23/2023 �l uos`4 l
415 N.STH STREET,Moo S.SHELTON wae9aM
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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 Heath 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 I-ennar Northwest,Inc Date: 8/23/2023
Mailing Address: 33455 6th Ave S,Unit I-B city,State.z4y. Federal Way,WA,98003
SlteAddress: Vi NEOlympic Ridge Phone: (Z3)2H-l3ss /!'�1��^
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Number: l�-5l-aaaes mS+es Permit Number: ip ��VU✓0
Part 2; Sewer System Information J
Name of Sewer System: aelfw ttl Site Plan attached?
Ofrclal use only: Sewer System Manager or Designated Employee is to complete.
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tatreapptlYq Mention County Peers.
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Must meet all Mason County design and construction standards,must pay all fees including:
Fw;nnection fee with anit and inspection fee,and latecaners charge(TBD)
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Pit r]t(3` Mason County Public Health Review)Approval
I[ASmustaGoy ❑ Unsatisfactory
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This form may be scanned and available for public view on the Mason County Web Site.