HomeMy WebLinkAboutBLD Sewer Adequacy - 8/21/2023 400529
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Application for Determination of Sewer Adequacy
Instructions:
1.Complete Part 1 of applicadon. 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 Meson 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 to proposed development and property.
Part 1:Applicant/Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 8/21/2023
Mailing Address; 33455 6th Ave S,Unit 1-A City,State,Zip: Federal Way,WA,98003
Site Atltlress: Ie0NEOmnpialLAV prone. (2531294-1322 Tom] �] /1 /�//^
Percal Number. 12328-51-0138 nSr139 Permit Number. B'�f{RIQ3 '1/Ol- /�7
Part 2:Sewer System Information
Nameot Sewer System Edfrr E4 Site Plan attached?
OHlcle/use only: Sewer System Manager or Designated Employee is to complete.
New comafiae I have rovpvtl the apP4unS,Mionnoon and have no osues mm Mason Cuunry Pu Heam asionnon9 he oanespunap
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Must meet all Mason County design and construction standards, must pay all fees
including:connection fee with permit and inspection fee anti Latecomers charge(TBID
Richard Dickinson 9/723
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Part 3:Mason County Public Health Reviewl Approval
❑ Satisfactory ❑ Unsatisfactory
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This form may be scanned and eventide for public view on Me Mason County Nib Site.
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