HomeMy WebLinkAboutBLD2005-00136 - BLD CD Environmental Health Review - 2/7/2005 MASON COUNTY
DEPARTMENT OF HEALTH SERVICES
February 07, 2005 PO BOX 1666 SHELTON, WA 98594
SHELTON (360)427-9670
FAX (360)427-7798
ELMA (360)482-5269
RITA MATSON BELFAIR (360) 275-4467
4500 SE FOSS RD SEATTLE (206)464-6968
PORT ORCHARD WA 98366
Case No.: BLD2005-00136 Parcel No.: 123305400008
Dear Applicant:
Your building permit cannot be approved by Mason County Environmental Health until
the following are completed and turned in:
aApplication for Water Adequacy
Please call me at(360)427-9670, ext. 353 if you have any questions.
Sincerely,
Cindy Waite
Environmental Health
Mason County Health Services
Comments:
217/2005 1 of 1 BLD2005A0136
PUBLIC WATER SYSTEM PURVEYOR
CERTIFICATE OF WATER ADEQUACY
I. WATER SYSTEM IDENTIFICATION
Name of Water System /„ 14'lepS ( T)e Z)41ta.2
WFI Identification Number
//06/-.9OL-
Name of System Manager /OHAvdlele- ` "`'Y'�""'�
0
II. SERVICE AREA IDSHTIPICASION �7
Total Number of Service Connections Approved by DOE
4-
Specific Lots Provided with Service Connections at Full Huildout of
Subdivision 0
M
M
III. STATEMENT OF ADEQUACY
I am manager of the above referenced water system. The water system
has DOH approval for the number of service connections specified above.
The system does not and will not serve any parcels other than those
listed above. Capacity of the system has been determined by the Wash-
ington Department of Health to be sufficient to provide adequater water
to applicants for determinations of water adequacy whose parcels are
listed above. Service of water to these applicants for domestic pur-
poses is consistent with both the water system plan aqd the water right
permit presently in effect. Water lines are available to all parcels
served by this water system or adequate arrangements, such as easements
and covenants, have been made to allow water service to all parcels
served by this water system. _
Syste Mana is Signatuare Date