HomeMy WebLinkAboutBLD Sewer Adequacy - 9/17/2024 812974
415 N.6TH STREET,BLD3 S.SHELTON M'
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MASON COUNTY
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Application for Determination of Sewer Adequacy Lok 5
Instructions:
1.Complete part 1 of application. pemhil number may be added at later data
2.Take application,SIM plan,and any other associated information with the proposed devslopr sm to the ScweT
System Manager m Designated Employee for approval.
3.Submit completed application and InfOrMation to permit Center or Mason County Public Haeth tar review.
NOTE:you must supply the System Manager with a Rite plan for the project,showing all astatine or proposed
.ewer components sari lines In rebfon to proposed development and property.
Part 1:Applicant I Parcel Information Dale_ 9117/2024
Applicant MTT CONSTRUCTION
Mailing Address. 16000 Christensen Rd Ste 150 Ciry,State,Zip:Tukwila,WA 98188
Site Address: 61 E COMPASS LN phone: 253-508-2156
Parcel Number. 12220-50-61005 Permit Number: (� 7-`T O I I I�LQJ
Part 2:Sewer system Information E S Jlle Plan attached?
Nema of Sewer system:North Bay Case Inlet
official use only: Sewer System Manager or Designated Employee is to complete.
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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,g0nnde�r plump fee(if applicable).
Richard Dickinson /Z�/���
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Paft S:Mason County Public Health Review/Approval gz-ft •_- „�atieFartory ❑ Unsatisfactory
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This form may he scanned and available for public vlaw on the Mason County Coounty Web site. ��