HomeMy WebLinkAboutBLD Sewer Adequacy - 8/21/2023 400549
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Application for Determination of Sewer Adequacy
Instrucnona:
t.Complete Pan f of application. Permit number maybe 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 Heart 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 t:Applicant I Parcel Information
Applicant: Sam Martin,Agent for Lennar Northwest,Inc Date: 812112023
Maaing Address: 33455 6th Ave S,Unit 1-B city,State,zip: Federal Way,WA,98003
Site Addmss: 91NEOI9m*Ridrt Phone: (253)N41312
Parcel Number 'Z2 5"WW3 HSa93 Permit Number 131 D202 —
Part 2:Sewer System Information
Name of Sewer System: Ikgar Ig Site Ran attached?
offi�cclal use oW, Sewer System Manager or DOSIW atecl PIOyee/s M comPlere.
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Must meNat all Mason County design and construction standards must pan,all fees
including:connection fee with permit and ins ion fee,and Latecomers cha e
Richard Dickinson 917/23
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Part t3: Mason County Public Health Review/Approval
RS Satisfactory UnsatisfactoryHDD �• �r �1 I (�"I
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This form may be Scanned and available for public view on the Moon county Web Site.
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