HomeMy WebLinkAboutBLD Sewer Adequacy - 9/20/2024 41E N.aTH STREET.SLOG a,WELTON WAes"I
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Application for Determination of SewerAdequacy
Instructions:
1.Complete Part i of application. Permil number may be added at lalerdam.
2.Take application,Site plan,and any other associated Information with the proposed develepment to the Sewer
System Manager or Designated Employee for approval.
3.Subma completed application and Information to Permit Center or Mason County Public Hearin for review.
NOTE:You must supply the Sysem Manager With a age.plan for the project,showing all aaiseng or proposed
sewer components and line.In rotation to proposed development and property.
Part 1:Applicant Parcel Information 9/20/2024
Applicant MTT CONSTRUCTION Dam:
Mating Address: 16000 Christensen Rd Ste 150 city,State,Zip: I ukwlla,WA 98188
Site Address: 101 E COMPASS LN Phorm: 253-508-2156
Parcel Number. 12220-50-61001 Perms Number: TW
Part 2:Sewer System Information
Name of Sasser System:North Bay Case Inlet L9rsim Peen atm4md't
M
etalrdy: Sewer System Managerw Designated Employee is m complete-
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mWq[ I IIM r—s'Ne epgkmle lnramelbn eM llew ro lmwa ufN Maem Cwnly PJNk HetlN eppm+llp nro wmeyikNa
our"Pe'MI.
Lonnalion: IMw rwlrneslN eppevhq NeWp Mown onunn,P..bweE Ne amaMe WMmM,s eM Mm eeremned wew sensf'mb menrN NOT-.1,a b NM popnN.W ee MwmB even meet all Mason County design and construction standards,must pay all fees including:ection fee with permit and inspection fee,grinder pump fee(if applicable).
ichard DickinsonNe 'MIsn MYNrr En[aryM / ~91PleentlaYYn Wl9orn{b/ee title
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Part($ Mason County Publlc Health Review)Approval
Satisfactory ❑ Unsatisfactory `
/ 5aman NEnrYan n�N Health sOerlellet
This form may be scanned and available for public view on lye Masson County Web Sib.
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