HomeMy WebLinkAboutWAT2025-00197 - WAT Application - 9/25/2025 ;. WAT 2025-Q0197
rrn,hy• .. MASON COUNTY
COMMUNITY SERVICES
{„ .„.`te Building Planning,Environmental Health,Community Heatth
415 N 6th Street, Bldg 8,Shelton WA 98584,
Shelton: (360)427-9670 ext 400 ❖ Belfair. (360)275-4467 ext 400 g. Elma:(360)482-5269 ext 400
FAX(360)427-7787
Application for Determination of Water Adequacy
Instructions
1. Complete Part 1. No determination can be made until Part 1 is fully completed.
2. Complete only the portion of Part 2 applying to the type of water connection utilized.
3. Submit completed application,with any required attachments for review.
4. An approved building site plan must accompany this application. _
Part 1: Applicant/ Parcel Identification
Name on Applicant: Foundation Building Materials Date: 9/19/25
Mailing Address: 2520 Red Hill Avenue Santa Ma,CA 92705 phone: 314-267-5943 Todd
Parcel Number: 123211400040
Type of Water System Reason for Application
Public/Community Water System (2 or more s Building permit #Com2025-00007
connections) 0 Division of land:
O Individual water source (one connection), #of Parcels? SPL
O Well 0 Boundary line adjustment
O Spring/surface water 0 Other(explain)
O Other(explain)
0 Replacement or Remodel (please indicate name
If you have more than one residence connected of water system below if applicable—no
to this well, check the Public/Community Water signature required)
System box.
Part 2: Water Connection Information EH APPROVED
Complete the section appropriate for the type of water connection being evaluated: Rhonda Thompson 09/25/2025
Public Water System
Name of Water System: Belfair Water District#1
Water Facility Inventory(WFI)Number: 053S0
(write"none"for two-party)
pil I am the manager of this water system. The water system has been approved for /yo3 services.
There are presently a& connection(s)in use.This will be the 701 connection.
0 I am the manager of this system.This connection will be to upgrade or change the use of an existing
connection on this system (i.e.: recreational to full time). Please indicate on the following line the nature
of this change:
This water system is able and willing to provide water to this (these)connection(s)without exceeding
the limits of the water system or arty'limits aet by state andAlocaljegulation.
Signature of Water System Manager �tG - _1 Date 4/14 DZ-S
Dale Webb *conditions added
This form may be scanned and available for public view at www.co.mason.wa,us.
J:\EH Forms\Drinking Water Revised 1/25/2018
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LSIAHi.!SHED 1966 1:04d,
September 23rd, 2025
RE: Conditions to be attached to Water Adequacy
Belfair Water District will be the water service utility provider for this project, and the
District believes that the water supply for this project is adequate the ability to supply is
based on the developers completion of the installation of the infrastructure as agreed in
the currently approved plans and DEA agreement. No connections to the water system will
be granted until the project is approved and completed per the Districts specifications.
White the District currently has capacity to supply this connection based on Available
ERU's, and as such is ready to allocate the necessary ERU's needed for this development.
based on lack of infrastructure serving distribution to this plat and until construction
installation and testing for this development is completed, service cannot be provided on
the parcel.
The District retains the right to withdraw this commitment should the developer back out of
the DEA or if the installation is not completed and approved by the District Board of
Commissioners.