HomeMy WebLinkAboutBLD Sewer Adequacy - 8/23/2023 y L)or�,2q
410 N.M STREET,811m O.SHELTON V0,985e4
MASON COUNTY s8ELTON M-275-98re,ExT 4W
COMMUNITY SERVICES eEELW.iXXW300@. .am1,"T.WB
ELtM:3W�4aH5238,EXT.400
.a&"M-1,Fmkenmenul WeOh C.—Il YWIh FP%1 W 4D-P90
Application for Determination of Sewer Adequacy
Instructions:
1.Complete Pert 1 of application. Permit number may be added at later date.
2.Take application,Site plan,and any other associated information with the imposed development to the Sewer
System Manager or Designated Employee for approval.
3.Submit completed application and Information to Permit Center or Mason County Public Heakh for revlavv
NOTE:You must supply the System Manager with a she plan for the project,showing all existing or proposed
sewer components and Tins In relation to proposed development and property.
Part 1:Applicant Parcel Information
Applicant Sam Martin,Agent for Lennar Northwest,Inc Date: 8/23/2023
Mailing Address: 33455 6th Ave S,Unit I-B city,State,Zp. Federal Way WA,98003
Site Address: laze-sl-IwmIyONE Dl4yyWICQ�GEntwne; (153)290-1322
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Parcel Number: 1232e.51430133 HS9133 Permitfl mb ' VIDA -
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Part 2: Sewer System Information By
Name of Sawer System: ➢elf tr L Site Plan attached?
iD/fficllal use only: Sewer System ManagOt"Destgnafed Employee ism complete.
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iMason Cwnly Pe,rtd1.
❑ CdsWp Gonnadbn: IM1eve rMeweO Ne eppbmnh lnlo,nwlion eM Mva mlcwesw9F Mann County P.M.HeelNeppmvia U,e
wneapwMirp Masan G ot,Pe,m1.
{ ❑—/T hew eeviwnl Na apptiun4lNmnelM a,dl,awtlelIXm'xEfewa,mnnealbn i[dnenly NOT avAtsMa to Nls papaly.
fpyne.,..aa ue wumua9�ne�nantJ=n aro�2aamana M.,on eaanb Pamlc faneawl
Must meet all Mason County design and Construction standards,must pay a8 fees including:
wnnectim f/eee with pertnit
ithpermit and inspection fee,and latecomers charge CMD)
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Part 3: Mason County Public Health Review/Approval
❑ Satisfactory ❑ Unsatisfactory
SMm9ae of EOWrdN'enW HeelOr$peda9al Dale
This form may be scanned and available for public view on the Mason County Web Site.