HomeMy WebLinkAboutBLD Sewer Adequacy - 11/7/2023 400492
415N ON5f M.MW B.MELTON M Ws"
MASON COUNTY SH LTON:a5a ?>W?0,IXT 400
400
COMMUNITY SERVICES aE""a'aao-a -MQ.EXT.
El-Mk'Y04B3-SZ80,IXT 400
9Ml^a eMarAY1.EmYmn is Ye Com fty Ynnh FM:% 27-7796
Application for Determination of Sewer Adequacy
Inswctions:
1.Complete Part 1 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 Health for review.
NOTE:you must supply me System Manager with a site plan for the project,showing all existing or proposed
sewer components and lines in relation W proposed development and property.
Part 1:Applicant I Parcel Information
Applicant Lauren Fafnis,Agent for Lennar Northwest,Inc Date: 11/7/2023
Mailing Address: 33455 6th Ave S,Unit 1-B city,State,Zip: Federal Way,WA,98003
sae Address:301 NE Belfair Station shams (B3)SW90165
Parcel Numbar. u31E-5'-taie r Pednft Number. BQZ 4—O0OfA
Part 2:Sewer System Information
Name of Sewer System: &Iwr Site Plan attached?
Fr
onty7 Sewer System Manages or Designated Employee Ism compbta.
EJ
alaAbn:Iarry Pa Cwm� cane-R.uYSrp Mace Cauay Peemil.eyiweE as apsoass lnanmem eM lvn mkmino ss rnorec is anN/NOT a"Nme w Pls prom"wa1M mesh._�o mae wnopm .-toady Pamn rea( o
et all Maso Co ty design and t ct' n t dards ust pas II feasding'connection fee with permit and inssppe�ctionfee,and Latecomers chargeard Dickinson /�^'Q'T�--�,.. 11t923
Hvm,✓SVa+^L� e�FnWYae alValued SYWnYYa�IeMA�r eaY
Part 3:Mason County Public Health Reviewl Approval
❑ Szfisfam ry ❑ Unsatistacary
SipraNrod Enwamen101 NaeIN SpedaOal Dale
This form may be scanned and available for public slew on the Mason County Web Site.