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HomeMy WebLinkAboutBLD CD Environmental Health Review - 9/18/2024 812975 115 N.M STREET,sloe 9,SHELNH W16aS06 a MASON COUNB,UX . TY ,'. .7.F T.400 COMMUNITY SERVICES EL weNbM'W4w FM:a9 V-nee BuAdbarNniM.anYmmenalWWlh�T^.^IM�eF Application for Determination of sewer Adequacy Instructions: 1.Complete Pad I Of application. Permit numoer may be added at later date. seed development ro he Sewer 2.Take application,Site plan,and any other associated information with the Prop System Manager or Designated Employee for approval. 3.Submit completed application and Information to Pemlil Center or Mason County Public Health for reties. theS slam Manager vdlhashe Plan for the pmfec%showing it eyj gng or proposed NOTE:You must supply Y 9 sewer component and lines In relation to proposed development and property. Part 1:Applicant I Parcel Information Data: 9I1612024 Applicant MTT CONSTRUCTION Tukwila,WA 98188 moing Address: 16000 Christensen Rd Ste 150 city.gone.Zip: Phone: 253-508-2156 SlsiteAddre 51 E COMPASS LNss: Parcel Number 12220-50-61005 Permit Number. Part 2:Sewer System Information ESita Plan attadh 7 Name of saver System:North Mason Case Inlet Manaflar or Daslgnarod Employee Is m complete. official use only: Sower Sysram HeMlh eoMadm lM�nwoi°na q tyw CpineeW: IM1ere rwMeL Ne.GW.e'e lnlnnuYonud Nve roNeuesvMM1 Meem Ceur'+/I+uEXe A.CmT1Y Pornil. ❑ ,,as.caroadim. llwererler.'eG tlw mOrr nb womeYm uWl wroloueowM Mown Lv+nlY Pudic HwIN wp^+iriO rFe .Ini N gMunnconn antra ❑ IpuluyeyaiYaPWYyne Y,danda ,and heu saddra dd°°aer wnnW n a Mmey NOT ardilade Id atls gcpnr e Fla...e ee rar ' enalodMal on We ddddp qhO Masan cu Fdnnit fwrru"n1 Must meet all Mason County design and construction standards,must pay all fees including: connection fee with permit and inspection fee,grinder pump fee of applicable). _ ��_ 09131✓z Richard Dickinson pen Fdd.e xen.denti^^N"°e°damdara s4+a„a snl.n M..oan ervYx� � Part Mason County Public Health Review/Approval I 1 '��aM Satisfactory ❑ unsatisfadory alanaheed Ere —n alH Ire slxdadt This form may be seen oel and available for public view on the Mason County Web Site. aeaewvnw.