HomeMy WebLinkAboutBLD Sewer Adequacy - 11/7/2023 400491
415N.sTH aTPEET.Inca S.SHELTON NNaWy4
MASON COUNTY SHELTnN:38w274610,CAT AM
COMMUNITY SERVICES aEtr"a'WO402.52es.E40
EIMA',3bo453316e,E%T,W
wwe,,aewnaaweox,xeW W.M,,cawanuvaenaa PAti34"V-rm
Application for Determination of Sewer Adequacy
InsWdlons:
t,Complete Part 1 of appliwlkm. Permit number may be added at later date.
2.Take application,Site plan,and any other associated formation with the proposed development to the Sewer
System Manager or Designated Employee for approval
3,Submit completed application and information to Permit Carrier or Mason County Public Heam for review.
NOTE:you must supply the System Manager with a she plan for the project showing all existing or proposed
sewer cam ponents and lines in relation to proposed development and property.
Part 1:Applicant/Parcel Information
Applicant Lauren Fafnis,Agent for Lennar Northwest,Inc Date: 1 1/7120 2 3
Mating Address: 33455 6th Ave S.Unit 1-B city,State,zip: Federal Way,WA,98003
t Site Address:311 NE Belfair Station Ph": (u3) .�Tsy02024
rl .r�
Parcel Number. rvze.stnoo3s Perms Number.T 02 0 24-007bS
t
Part 2:Sewer System Information
Name of Sewer System: adralr [`� She Plan alt3credi
officral use oNy: Sower Sysem Manager or Oaslgn W Employee is m comp/eta.
' p New Cmneclbn: 111aro iaNwla]Iae applluMS lnlcrmelim aM M1eve no iaswawiW Main eeunb Putf[NeNN aLpwl,N nn mnagv,M,q
Ei
I Mews Dpunly Pemit
FvsNp Connbun: Ihm,eMeweClM1e apdiunb irefineticn eM Mve,w lssuw WMh MawnCwnry PuWk HeYN eppmvi,q Vw
' twrtawMinB Maven County PerM[
I M1ew ra/iewMtM appYcanlalNwmaEm aM MwtlalamNetl aseer mnneNim aerrantry NOTevxiWeek"ne apeny.
fer peen sea merdwwms�oswxq on anoa,.we.,ere etxo„cwm Prom(rove,+M
Must meet all Mason County design.and construction standards,must pay all fees
including:connection has with permit and inspection fee,and Latecorners charge(TBD).
Richard Dickinson 111e123
m-w xw,wdsyAamMwweeJEnxbR. fiowu.damxn N.np.lfaMyr °"'
Part 3:Mason County Public Health Reviewt Approval
❑ sea factory ❑ Unsatisfactory agreWe d EnWmmnM HeeM SpeAkdhR Dale
This form may be scanned and available for public view on the Mason County Web Site.
neeamsmamx