18-104543City or Federal way
Community Development Dept.
33325 Sth Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: NORTHLAKE POINT LLC LOT 6
Project Address: 3102 S 337TH ST
Building - Single 'Family
Permit #:18-104543-00-SF
Inspection Request Line: (253) 835-3050
Parcel Number: 442060 0030
Project Description: NEW - Construction of a 2-story, 4147 square foot single family residence with a 933 square
foot attached garage, including plumbing and mechanical. *** 3 bedrooms; S560,000
estimated selling price***
Owner
Applicant
Contractor
Lender
NORTHLAKE POINT LLC
IRINA DMITROYCHUK
V V L CONSTRUCTION LLC
OWNER IS LENDER
3098 S 337TH ST
24913 104TH AVE SE
31627 44TH AVE S
FEDERAL WAY WA 98001
KENT WA 98030
AUBURN WA 98001
Census Category: 101 - New Single Family House
Includes:
# 1
#2
43
#4
Occupancy Class:
R-3
Construction Type.,
Type V - B
Occupancy Load:
Floor Area (sq. ft.)
0.00
Additional Permit Information
New / Additional Sq. Feet - lst Floor .....................
2902
New / Additional Sq. Feet - 3rd Floor.... .... ........
0
New / Additional Sq. Feet - Basement ....................
0
Occupancy #1 - Construction Type .........................
Type V - B
New / Additional Sq. Feet - Garage ........................
933
Plumbing Work Valuation? .....................................
10000
Number of Stories ...................................................
2
Plumbing to be Included? ........................................
Yes
Will Certificate of Occupancy be Issued? ...............
Yes
Comprehensive Plan Designation
Total Valuation: 545,347.65
Ducting
Furnaces
Hot Water Tanks
Bathtubs
Lavatories
Water Closets
SF - High -Density
Residential
New / Additional Sq. Feet - 2nd Floor .................... 1245
................
Occupancy # I - Area (Sq. Feet) .............. 0
BasicPlan?...........................................................
No
New / Additional Sq. Feet - Deck .................... :......
0
Mechanical to be Included? .....................................
Yes
Mechanical Work Valuation?.... .............................
10000
New / Additional Sq. Feet - Other., .................. I ...... 0
New / Additional Sq. Feet - Total., ..................... 1...
5080
Occupancy #I -Use .............. ..................................
Residence (1 or 2
• family)
.......................
Zoning Designation .................................................
RS 9.6
Mechanical Fixtures
1 Fans
1 Gas Piping
1
Plumbing Fixtures
2 Dishwashers
5 Showers
3 Hose Bibbs
CONDITIONS:
4 Fireplace Inserts
1 Gas Pipe Outlets
] Laundry Washer Outlets
1 Sinks
2
1
4
LResidential Fire Sprinkler System required. NO FRAMING INSPECTION PRIOR TO
INSTALLATION OF FIRE SPRINKLERS UNDER SEPARATE PERMIT
2. Height survey shall be provided to the City for review and approval at the time of under floor framing
inspection and prior to final.
1. Permanent Split Rail Fence and Critical Area signs required algng the wetland buffer edge. Prior to
issuance of a Certificate of Occupancy on residence, please contact Becky Chapin, Associate Planner, at
253-835-2641 for a planniath final for verification on fencelsign install.
PERMIT EXPIRES Wednesday, 6 May, 2020
Permit Issued on Friday, November 8, 2019
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the useA be in accordance with the laws, rules and regulations of the State of
shington and the City of Federal Way.
Owner or agent:
City of Federal Way
Certificate of Occupancy
Date: Ar 0C — l
This Certificate issued pursuant to the requirements of Section 111 of the International Building Code or Section
R110 of the International Residential Code is certifying that at the time of issuance, this structure was in
compliance with the various ordinances of the City regulating building construction or use. This certificate is valid
ONLY when endorsed by City staff.
Tenant Name: NORTHLAKE POINT LLC LOT 6
Address: 3102 S 337TH ST
Permit # 18-104543-00-SF
Includes: # 1 #2 #3 #4
Occupancy Class: R-3
Construction Type: Type V - B
Occupancy Load: 0.00
Floor Area (sq. ft.) 0.00
Owner Name: NORTHLAKE POINT LLC
Owner Address: 3098 S 337TH ST
FEDERAL WAY WA 98001
B iilding Official
6 Z3-z
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severely affect the health and safety of the general public. Although the City has made as complete
a review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees
nor warrants to the owner/occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and/or occupant of the premises.
r A:
CITY OF
Federal Way
-'Y
THIS CARD IS TO REMAIN ON -SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
PERMIT #: 18 104543 00 Address: 3102 S 337TH ST
Project: NORTHLAKE POINT LLC FEDERAL WAY WA
Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE `[7 [1S C kRD. Inspections are listed as close to sequential order as possible
(read left to right, top to bottom). Please schedule inspections
as appropriate. Work must not be covered until it is approved. Check with your inspector if
you are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card.
El SWM Precon Site Mtg (4400) 0
Initial Erosion Control (4365) 0 Footings/Setback (4110)
Approved
To be done PRIOR to breaking ground Approved to place concrete
By Date By
Date By/ Date
0 Foundation Wall (4115)
Drainage/Downspout (4040) ❑ Plumbing Groundwork (4190)
Approved w place concrete
Approved to backfill Approved to cover
ByLGtI Date i' 4V By
Date By Date
El Slab/Concrete Floor (4255) 0
Underfloor Framing (4285) ❑ Floor Sheathing (4105)
Approved to place concrete
Approved to sheath floor Approved to install flooring
By Date By
Date By Date
El
Shear Walls (4245)
El
Roof Sheathing (4220)
I2
Rough Plumbing (4230)
Approved to install siding
Approved to install rooting
Approved
By
Date
By
Date
By
Date
❑
Mechanical Rough -in (4165)
Ea
Gas Piping (4125)
0
Fire/Draft Stops (4095)
Approved
Approved to release test
Approved
By
Date
By
Date
By
Date
❑
By
Interim Erosion Control (4370)[and
Approved
Date
rior to scheduling a Framing inspection;
ctrical, Plumbing & Mechanical Rough -in
Fire/Draft Stop inspections must be signed -
off and approved. IBC 109.3.4
1 +'
By
Framing (4120)
Approved to insulate
Date
1ii
By
Insulation (4150)p
Approved to install wallboard
Date
By
Gypsum Wallboard Nailing (4130)
Approved to install mud & tape
Date
By
Final Erosion Control (4375)
Approved
Date
❑
By
Final - Mechanical (4065)
Approved
Date
❑
By
Final - Plumbing (4075)
Approved
Date
rayl-�
Final - Building (4050)
Approved
LL Date G12�212117.
sPr;'V"'k'� Lc
❑
Rough Electrical
❑
Final Electrical
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
THIS CARD 1S TO REMAIN ON -SITE �
C17Y6i: C01ISt" eiOn Inspection Recorda ederal Way INSPLe. OI1 REQUESTS. (253) 835-3050
PERMIT #:
Project:
18 104543 00 Address: 3102 S 337TLI ST
NORTHLAKE POINT LLC FEDERAL, WAY WA
Scheduled inspections may be failed it'this earl is not on -site. DO NOT LOSETHIS CA1113. Inspections are listed as close to sequential order as possible
(read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with Your inspector if
3rou are unsure about any of the inspections or the inspection sequence. On -going inspections are logged on the back of this card.
❑ SW,,N4 Precon Site Mtg (4400)
❑. Initial Erosion Control (4365)
❑ Footings/Setback (4I10)
Approved
To be done PRIOR to brakiiig around
Approved to place concrete
By ,; Date i :, ''.� ,-?,!t
By �`) `; Date
13a Date;
❑
Foundation Wall (4115)
❑ Drainage/Downspout (4040)
Approved to place concrete
Approved to backllll
By f Date),"7 f
By Date
❑
Slab/Concrete Floor (4255)
❑ Untlertloot- Framing (428.5)
Approved to place concrete
Approved to sheath floor
By
Date
By Date
M1
❑
Plumbing Groundwork (4190)
Approved to cover
By
Date
❑
Floor Sheathing (4105)
Approve„ to install tloonng
By
Date -
Shear Walls (4245) ❑ Roof Sheathing (4220) ❑ Rough Plumbing (4230)
ApproNud u• install sidin.g Approved to install roofing ApprOV-%:d
Et t ;late. By Date B} Date
❑ _ Nlec•hanical Rwngh-in k4165) ❑ Gas Piping (4125)
Approved Approved In release tesr
By Date _ By Date
❑ Intel-hn El-osion-C.-mi-ol (4370) Prior to scheduling a1-ramingiospecdon;�
ApproNcd Electrical, Plumbing & Nlechanical Rough -in
aid Fire/Draft Stop inspections must be sigued-
By Date offand approved. IBC 109i
❑ insulation (4150) ❑ Gypsum Wallboard sailing (4130)
Approved to install wal urrd Approved to install inud X: tape
qy Date By A.1 Date
C; Final •- INiechanical (4065) ❑ Final - Plumbing (4075)
Approved Approved
By Date By llate
.46/a5l.o A4/5; I Z, Z.
ON
By
By.
Fil•eiDvaft Stotts (4095'.
A;piuved
` Date�j��
Framing (4120)
Approved to msui.::_
�0 Date I�7,"
Final Erosion Control (435)
ApptONed
By Date
Final - Builc:i,1R (4050)
Approved
By Date
7 API
Rough Electrical ❑ hElinal Electrical Right of Wad
Approved. Approved Approved
B� �.. Date i.�B�.....,.�._ `aate�.._. By Date ��
Bruce S. MacVeigh, P.E.
Civil Engineer/Small Site Geotechnica/
14245 59th Ave. S.
Tukwila, WA 98168
Cell: 206-571-8794
July 15, 2020
City of Federal Way
Attn: Building Official/Field Inspector
danie1fedwayvisit071520a12036
Subject: Site Visit Evaluation - Crawls ace Post to Pad Connection, New Residence,
3102 S. 337th Street, Federal Way, WA 98001 (PN: 442060-0030)
Permit Number: 18-104543 Owner- Northlake Point, LLC
Legal Description: LOUISAS NORTH LAKE TRACTS, KING COUNTY, WASHINGTON
Dear Sir:
The above residence under construction was visited on this date to observe and evaluate
work requiring further field review.
WORK REVIEWED:
Pony posts in crawlspace not positively connected to concrete pads.
OBSERVATIONS:
All 4" x 6" PT posts were in place. Pads are round concrete about 30" in diameter. Note:
Several posts did have connection.
RECOMMENDATIONS:
That all posts receive positive connection to concrete pads. Connection to be with 2
each A35 clips (Z) at bottom of each post. Connect to post with Teco nails (Z). Connect
to concrete pad with minimum of 3 each 12d ram -set nails (Z) for each clip. All posts did
have in place shingle moisture barriers. Note that these connections are not structurally
important since seismic forces will not directly act at post base locations.
ADDITIONAL NOTE: Observed was exterior crawlspace access 32" wide x 24" high,
meeting crawlspace access requirements.
Thank you for your assistance.
Sincerely,
Bruce S. MacVeigh, P.E.
Civil Engineer
danielfed wa yvisit07 9 520a12036
41k
CITY OF �P
Federal Way
PERMIT NUMBER I b
RECEIVE® PERMIT APPLICATION
SEP 2 5 2018 PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcente t cityoffederalway.com
CITY ()F FEDERAL WAY C
��OMMLINITY DEVELOPMENT _ J
TARGET DATE O
SITE ADDRESS SUITE/UNIT #
3I01 S, 33'?-- ,S--+,
PRO�J[ECT VALUATION ZONING ASSESSOR'S TAX/PARCEL #
00 coo
TYPE OF PERMIT
BUILDING %PLUMBING ,-MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
S� `^
be included on this permit only
NAME
PRIMARY PHONE
t 0(,) `� 32 1 C�
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY Y-e1,4
SvTAJT
ZIP'78 0�> a
NAME
-T Vb
PHONE
MAILING ADDRESS
E-MAIL
CONT4CTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME - --
�lMl�
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
APPLICANT,
CITY STATE ZIP
FAX
PROJECT CONTACT
NAME
-xlAll
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
When value is $5,000 or more
(RCW 19.27.095)
NAME
OWNER -FINANCED
1
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE: DATE 2
PRINT NAME:�� ! f ruY
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\HandoutsTermit Application
MECHANICAL PERMIT VALUE OF MECHANICAL WORK
$ / L'' -�?
Indicate how vmny of each type off4yre to be installed or relocated as part of this profect. Do not include ex'isting fwtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER �` FIREPLACE INSERTS HOODS (commercial)
BOILERS �- FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
VALUE OF PLUMBING WORK
$ U 00 D
Indicate how mcxny of each
type o ure to be installed or relocated as ar[ ❑ this project. Do not include ti fixtures to remain.
BATHTUBS (or Tub/ShowcrCombo) LAVS (HondSi kc)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS URINALS
OTHER (Describe)
DRPMNS
�r SHOWERS
VAC;JUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
—LL TOTALFIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
XxImit, PPREVIOUS USE
LOT SIZE (In Square Feet)
3/ 2 l
EXISTING FIRE SPRINKLER SYSTEM?
❑ Yes Xi No
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes $- No
7—
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
-zg V 2-
.2 q V L
SECOND FLOOR
2,L(
2l t
COVERED ENTRY
DECK
GARAGE X CARPORT ❑
Q
1
OTHER (describe)
Area Totals
EXISTING
P OSGG
TOTAL
*NEW HOMES ONLY**
2
ESTIMATED SELLING PRICE # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s)
SSjuare Feet
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s)
Square Feet
TOTAL BUILDING
TENANT AREA ONLY
Construction I # of
Type Stories
Additional Information
Construction # of Additional Information
. Tvpe _ , Stories _ _ --.-
PROJECT AREA ONLY
Bulletin #100 - January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application
N � w�� cel��
COMMU FITY DEVELOPMENT DEPARTMENT
33325 81h Avenue South
FEB 41 �.l. r Federal Way, WA 98003-6325
CITY OF 253-835-2607; Fax 253-835-2609
Federal Way CIPs F)� r FWRAL WAY wwW.ci tyoffeaeralway com
- .
SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT
EXEMPTION APPLICATION
File # I I- 100 5 0 0— OD — S TT
TO BE COMPLETED BY APPLICANT
Project Name: �o( n �G L�k.S QeeY ezy'wW
Project Address: (4 y Z p(v D 00 3
Applicant: LL fnav�r, e,", e c-►4
Mailing Address: 2yq 13 04J'b s�
Phone Number: Zc Ea-'$col�34 ze> E-mail: ��tto p�f c�vt�w 5 ,rnw I, co a-,
Description of Project: 0'e'(_ z
as C. V 1oc hm Y `W .) i 6e ULC
Meets the criteria for exemption under which section of * WAC 173-27-040:_���
*Washington Admit ative Code online: apps.le .wa.goy
Applicant's Signature
-21�—
Date
Bulletin 4143 —March 25, 2013 1 of 2 k:\Handouts\Shoreline Exemption
RECEIVED
SEP 2 5 2018
Go i;l OF WAY
i = .i.
AMSOWN
WATER & SEWER DISTRICT
-c - `-40 ,
Lakehaven Water & Sewer District - Development Engineering Section
31623 - 1st Ave S * PO Box 4249 * Federal Way, WA 98063-4249
Telephone: 253-945-1581 or 253-945-1580 * Email: DE@Lakehaven.org
This certificate is intended to provide the applicant, lard use agencies &/or public health departments with
Information necessary to evaluate development proposals. Lakehaven Water & Sewer District, at its sole
discretion, reserves the right to delay, or deny, waterjservice based upon capacity &/or supply limitations
In Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permit-SFR ❑ Building Pe�imlt-MFR ❑ Building Permit -Other
❑ Subdivision ❑ Short Subdivislon ❑ Binding Site Plan
❑ Rezone ❑ Boundary Line Adjustment
❑ Other (speclfy/describe)
Tax Parcel Number(s): 4420600030 Site Address: Lakehaven GIS Grid:
Ex. Bldg. Area to Remain: N/A sf New Bldg. Ares Proposed: 2,500 sf
Applicant's Name: ILL Management LLC
WATER SYSTEM INFORMATION
1. ® Water service can be provided by service connection to an existing !E diameter water main that Is on the site.
2. ❑ Water service for the site will require an Improvement to Lakehaven's water distribution system of:
❑ a. feet of " diameter water main to reach the site; and/or
❑ b. The construction of a water distribution system on the site; and/or
❑ c. A major portion of Lakehaven's comprehensive water system plan would need to be implemented and/or
constructed; and/or
❑ d. Other (describe:):
3. ® a. The existing water system Is In conformance with Lakehaven's Comprehensive Water System Plan.
❑ b. The existing water system Is not In conformance with Lakehaven's Comprehensive Water System Plan and an
Amendment to this Plan will be required, This may cause a delay In Issuance of land use approvals or permits.
4. ® a. The subject property Is within the corporate limits of Lakehaven Water & Sewer District, or has been granted
Boundary Review Board approval for extension of water service outside of Lakehaven's water service area.
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
S. Water service Is subject to:
® a. Payment of connection charges (to be determined by Lakehaven);
® b. Proof or reservation of easement(s) as required by Lakehaven;
® c. Other: Water Service Conn boftn-M5 glred•
Comments/special conditions: Sermim r L I i s
. - -.-- - . ---- �� �_ �..i...,. r.,, —irl enrrnnrhmpnF iinnn Axrst3na Water_
r n -.. o
The nearest fire hydrant is approximately 112±L- feet from the Propert (as marked on map on the back of this page).
Fire Flow at no less than 20 psi avaliable within the water distribution system Is 1,000 GPM (approximate) for two (2) hours or more.
This flow tion system under
gh demand conditlons. Fir
ow rates
greater than rth sepmay the accommodated o through water distribut dater istribution Improvements, icontact Lakehaven for l additional
Information.
334 Pressure Zone Est. Future Meter Elevation-GIS: 100+/- Est, Pressure Range at Future Meter (psi): Min. 95, Max. 101
I hereby certify that the above water system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY Title: VEOF QR
Signature:.- Date:
3222049035 wtr.docx (Form Update 1/3/17) Page 1 of 2
33636
4420600015
3106
2..
---�-----------------------------------•-------SXVT ►5r.--------------- -- =_
sz" 12"
Ryq�Us�R
S
ROTE: Lakehaven Utility District
neither warrants nor guarantees the
accuracy of any facility information
provided. Facility locations and
conditions are subject to field
�ktry n,00 verification.
6142600005
33663
Summer Lots Short Plat (15-100738-00-PC)
100
Feet
16
200
IWO
a >{ RECEIVE®
Icing County SEP 2 5 2018
Department of Permitting
and Environmental Review iY OF Fri ll- WAY
Snoqu Douglas Street, SuIt89UNm DEVELOPMENT —
Snoqualmie, WA 98065-9266
S06 Web dale: 11/0912012
Sewer Availability:
King County Certificate of L-11
Sewer Availability ERU
II-e4
206-296-6600 TTY Relay: 711 For alternate formats, call 206-296-6600.
www.kingcounty.gov
This certificate provides the Public Health - Seattle & King County Department and the Department of Permitting
and Environmental Review with information necessary to evaluate development proposals
Do not write in this box
Number
Building Permit
❑ Short Subdivision
❑ Preliminary Plat or PUD
❑ Rezone or other:
Applicant's name: Wasq ngton Federal
Proposed use: [ L_,JienlialptS
Location (attach map and legal description If necessary):
Adjacent to 3106 S 337th, Auburn
Name
-Sewer q9ency information:
1. a. Sewer servicecan be provided by side sewer connection only to an existing 19 � size sewer
± feet from the site and the sewer system has the capacity to serve the proposed use,
OR
b. Sewer service will require an improvement to the sewer system of:
U[ (f) �>� t feet of sewer ifundi op lateral to reach the site; andit
❑ (2) The construction of a collection system on the site; and/or
Y14(3) Other (describe): EKTt✓ NSl4n1'�m+�
2. 9 a. The sewer system improvement is in conformance with a County approved sewer comprehensive plan.
OR
❑ b. The sewer system improvement will require a sewer comprehensive plan amendment.
3 ls� a. The proposed project is within the corporate limits of the district or has been granted Boundary Review Board
OR approval for extension of service outside the district or city.
1-1 b. Annexation or Boundary Review Board (BRB) approval will be necessary to provide service.
4 Service is subject to the following:
a. Connection charge: _T-0 cAL.CQS.
b. Easement(s): GZ [�
C. Other:WE2 _S�RV t—I�1Lp sJ,��5
r.,,,,,,,.,.,.... To E%EGt�T(O rJ O`r SERV lip �'rGR�I►I�tENTS ,
* The District, at its sole discretion, reserves the right to delay or deny server service based upon capacity limitations in District and Other Purveyor facilities. *
I certify that the above sewer agency information is true. This certification shall be valid for one year from date of
signature.
LAKEHAVEN UTILITY DISTRICT
,JencV name _ yn ory name
19115
Title Signature Date
SewerAvailabilityFORM. doc b-cert-sewer.pdf S06 11/09/20'12 Page 1 of 1
4420600060
4420600050
33636
4420600045
4420600040
R� S
NOTE: Lakehaven Utility District
1 neither warrants nor guarantees the
]1+� accuracy of any facility information
provided. Facility locations and
n
iWa conditions are subject to field
AUTILITi,40 verification.
S 337TH ST
4420600015
3106
6142600005
33663
3116
Certificate of Sewer Availability
Parcels 4420600025 & 4420600030
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