17-101154City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: EAGLE MANOR LOT 5
Project Address: 2110 SW 344TH CT
Building - Single Family
Permit #:17 -101154 -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 214121 0050
Project Description: NEW - Construction of a 3,253 square foot, 2 -story single family residence with a 26 square
foot covered entry, a 55 square foot deck and a 674 square foot attached garage, including
plumbing and mechanical. *** 6 bedrooms; $400,000 estimated selling price***
Owner
Applicant
Contractor
Lender
SSHI LLC, DBA D R HORTON
CAMBRIA SMITHSSHI LLC, dba D
D R HORTON
OWNER IS LENDER
910 TOTEM LAKE BLVD SUITE 2
R HORTON
10 NE TOTEM LAKE BLVD SUITE.
New / Additional Sq. Feet - Basement ....................
KIRKLAND WA 98034
910 TOTEM LAKE BLVD SUITE 2
KIRKLAND WA 98034
Occupancy #1 - Construction Type .........................
Type V - B
KIRKLAND WA 98034
55
New / Additional Sq. Feet - Garage ........................ 674
Census Category: 101 - New Single Family House
Includes:
# 1 #2 #3 #4
Occupancy Class:
R-3
Construction Type:
Type V - B
Occupancy Load:
New / Additional Sq. Feet - 3rd Floor .....................
Floor Area (sq. ft.) 1
3,253.00 1 0.00
Plumbing to be Included? ........................................ Yes dditional Sq. Feet - Total........................... 4008
Will Certificate of Occupancy be Issued? ............... Yes Occupancy #I - Use................................................ Residence (1 or 2
family)
Comprehensive Plan Designation ........................... SF ensity Zoning Designation................................................. RS 7.2
Total Valuation: 402,320.16
Air Conditioners - Stand Alon(
Fireplace Inserts
Gas Pipe Outlets
Bathtubs
Lavatories
Water Closets
1 Ducting
1 Furnaces
6 Hot Water Tanks
2 Dishwashers
6 Showers
4 Hose Bibbs
1 Fans 5
1 Gas Piping 1
1
1 Laundry Washer Outlets 1
2 Sinks 2
2
CONDITIONS:
1) One tree shall be planted on the lot prior to final inspection. Either a minimum ten foot evergreen or a
minimum three inch calip"eciduous tree.
Additional Permit information
New/ Additional Sq. Feet - 1st Floor .....................
1513
New / Additional Sq. Feet - 2nd Floor....................
1740
New / Additional Sq. Feet - 3rd Floor .....................
0
Occupancy #1 - Area (Sq. Feet)..............................
3253
New / Additional Sq. Feet - Basement ....................
0
Basic Plan? ...........................................................
No
Occupancy #1 - Construction Type .........................
Type V - B
New / Additional Sq. Feet - Deck ...........................
55
New / Additional Sq. Feet - Garage ........................ 674
Mechanical to be Included?.....................................
Yes
Plumbing Work Valuation? .....................................
10000
Mech Valuation?..................................
10000
Number of Stories ...................................................
2
Sq. Feet - Other...........................
26
Plumbing to be Included? ........................................ Yes dditional Sq. Feet - Total........................... 4008
Will Certificate of Occupancy be Issued? ............... Yes Occupancy #I - Use................................................ Residence (1 or 2
family)
Comprehensive Plan Designation ........................... SF ensity Zoning Designation................................................. RS 7.2
Total Valuation: 402,320.16
Air Conditioners - Stand Alon(
Fireplace Inserts
Gas Pipe Outlets
Bathtubs
Lavatories
Water Closets
1 Ducting
1 Furnaces
6 Hot Water Tanks
2 Dishwashers
6 Showers
4 Hose Bibbs
1 Fans 5
1 Gas Piping 1
1
1 Laundry Washer Outlets 1
2 Sinks 2
2
CONDITIONS:
1) One tree shall be planted on the lot prior to final inspection. Either a minimum ten foot evergreen or a
minimum three inch calip"eciduous tree.
PERMIT EXPIRES Monday, 9 October, 2017
Permit Issued on Wednesday, April 12, 2017
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
Owner or agent: Date:
City of Federal Way
Certificate of Occupancy
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: EAGLE MANOR LOT 5
Address: 2110 SW 344TH CT
Includes: 41 #2 93
Occupancy Class: R-3
Construction Type: Type V - B
Occupancy Load: 0.00
Floor Area (sq. ft.) 3,253.00 0.00
Owner Name: SSHI LLC, DBA D R HORTON
Owner Address: 12910 TOTEM LAKE BLVD SUITE 22
KIRKLAND WA 98034
Building Official
Permit # 17 -101154 -00 -SF
#4
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.
" 1
CITY OF '
Federal Way
PERMIT #: 17 101154 00
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
Address: 2110 SW 344TH CT
Project: SSRI LLC, dba D R HORTON FEDERAL WAY WA 98023
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. 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.
®
SWM Precon Site Mtg (4400)
®
Initial Erosion Control (4365)
® Footings/Setback (4110)
Plumbing Groundwork (4190)
Approved
Approved to place concrete
To be done PRIOR to breaking ground
Approved to place concrete
By
Date
By
Date
By C'�v Date s -t i f- — 4-i
Q
Foundation Wall (4115)
®
Drainage/Downspout (4040)
®
Plumbing Groundwork (4190)
By 19 T Date
Approved to place concrete
r
By ,,_ ; ., Date -7�f t. / —7
Approved to backfill
Approved to cover
By
Date S 1 ^ . 1 .
By
DateBy
By 0
Date S- _ _t
®
Slab/Concrete Floor (4255)
®
Underfloor Framing (4285)
®
Floor Sheathing (4105)
By 19 T Date
Approved to place concrete
r
By ,,_ ; ., Date -7�f t. / —7
Approved to sheath floor
Approved to install flooring
By
Date
By
Date
By 0
Date 1a . �._
's t3
Shear Walls (4245)
Fire/Draft Stops (4095)
Roof Sheathing (4220)
12
Rough Plumbing (4230)
By 19 T Date
Approved to install siding
r
By ,,_ ; ., Date -7�f t. / —7
Approved to install roofing
Approved
By
Date >b _ _ 1.1
By
L, Date L r 77-11
By
f f Date'
13 Mechanical Rough -in (4165)
4 Gas Piping (4125)
Fire/Draft Stops (4095)
Approved
Approved to release test
Approved
By 19 T Date
By Date
r
By ,,_ ; ., Date -7�f t. / —7
Fl -61 Interim Erosion Control (4370) Prior to scheduling a Framing inspection; 17 Framing (4120)
Approved Electrical, Plumbing & Mechanical Rough -in Approved to insulate
and Fire/Draft Stop inspections must be signed -
By Date off and approved. IBC 109.3.4 By , Date q—(
1g Insulation (4150)
i9 Gypsum Wallboard Nailing (4130)
20 Final Erosion Control (4375)
Approved to install wallboard
Approved to install mud & tape
Approved
By Date —'A
c Date '�- J 7 4J 1-7
By Date
1
Final - Mechanical (4065)
Final - Plumbing (4075)
23
Final - Building (4050)
❑
Approved
Approved
Approved
By
Date 41 17
By
Date `F '1 1"1
By
Date C7
D
Rough Electrical
Final Electrical
❑
Right of Way
Approved
Approved
Approved
By
Date
By
Date
By
Date
CITY OF Building Division
33325 Eighth Avenue South
Federal Wa Federal Way, 98003-6325
y Phone 253-835-2607 Fax
253-835-2609
CORRECTION NOTICE
ADD SS: G��a)t ►vtGnor2 PERMIT#: 17 - /0) 1 561
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rl
'/J 30 n c- ✓y1oce-
IF YOU HAVE QUESTIONS CALL ntQ y (253)835-
WHEN
253)835-WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
�� 1j� Page of
It
Lot
RECEIVE®
ERMIT APPLICATION
CITY OF MAR 10 2
'� RMIT CENTER + 33325 8th Avenue South +Federal Way, WA 98003-6325
Federal 253-835-2607 + FAX 253-835-2609 + permiteenter!dcitvoffederalway.eonl
CITY OF FEDERAL WAY
COMMUNfTY DEVELOPMENT
PERMIT NUMBER _ 10 — 'f'--
/ TARGET DATE
SITE ADDRESS
SUITE/UNIT #
2110 SW 344TH COURT, Federal Way, 98023
LOT # 5
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL # 214121-0050
$ 100,000.00
TYPE OF PERMIT
BUILDING K PLUMBING iMECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Eagle Manor
PROJECT DESCRIPTION
Detailed description of work to
Construct a New SFR w/ attached 3 car garage at Eagle Manor, LOT # 5
be included on this permit only
NAME
PRIMARY PHONE
SSHI LLC, dba D.R. Horton
(425) 821-340OX 5172
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
12910 Totem Lake Blvd #220
csmith drhorton.com
CITY
Kirkland
STATE
WA
ZIP
98034
NAME
SSHI LLC, dba D.R. Horton
PHONE
(425) 821-340OX 5172
MAILING ADDRESS
12910 Totem Lake Blvd #220
E-MAIL
csmith drhorton.com
CONTRACTOR
CITY Kirkland
STWA
ZIP 98034
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
DRH R**963CS
08//03// 17
NAME
SSHI LLC, dba D.R. Horton
PRIMARY PHONE
425 821-340OX 5172
MAILING ADDRESS
12910 Totem Lake Blvd #220,
E-MAIL
csmith@drhorton.com
APPLICANT
CITYSTATE
Kirkland
WA
ZIP
98034
FAX
PROJECT CONTACT
NAME
Cambria Smith
PRIMARY PHONE
425 821-340OX 5172
(The individual to receive and
respond to all correspondence
MAILING ADDRESS
12910 Totem Lake Blvd #220
E-MAIL
csmith@drhorton.com
CITY
STATE
ZIP
FAX
concerning this application)
Kirkland
WA
98034
PROJECT FINANCING
NAME
Cambria Smith
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
12910 Totem Lake Blvd #220 Kirkland WA 98034
425 821-340OX 5172
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 as apart of this application.
eccity
�'�'"`" �""
SIGNATURE: —`--- DATE 3-2-16
PRINT NAME: Cambria Smith
Bulletin #100 – January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N/A Lakehaven Utility District L.akehaven Utility District $ N/A
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
N/A 7,320 Yes g No ❑ Yes A No
RESIDENTIAL -NEW OR ADDITION
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
PROPOSED
$ 10,000
Indicate how many of each type offixture
to be installed or relocated as part
of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
5 FANS 6
GAS PIPE OUTLETS
OTHER (Describe)
1 AIR CONDITIONER
I FIREPLACE INSERTS 1
HOODS (comme,ciai)
OTHER (Describe)
BOILERS
1 FURNACES 1
HOT WATER TANKS (Gas(
COMPRESSORS
GAS LOG SETS 1
REFRIGERATION SYST
19 TOTAL
1 DUCTING
1 GAS PIPING
WOODSTOVES
26 TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N/A Lakehaven Utility District L.akehaven Utility District $ N/A
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
N/A 7,320 Yes g No ❑ Yes A No
RESIDENTIAL -NEW OR ADDITION
VALUE OF PLUMBING WORK
PLUMBING PERMIT
PROPOSED
$ 10,000
Indicate how many of each type offixture
to be installed or relocated as part
of this project. Do not include existingfixtures to remain.
4 BATHTUBS (or Tub/Shower combo(
5 LAVS (Hand Sinks) 6
TOILETS
1 WATER PIPING
1 DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
4 SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
2 SINKS (Mtchen/Utility) 1
WATER HEATERS (Electric)
1 HOSE BIBBS
SUMPS 1
WASHING MACHINES
26 TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N/A Lakehaven Utility District L.akehaven Utility District $ N/A
EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
N/A 7,320 Yes g No ❑ Yes A No
RESIDENTIAL -NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
1513
1513
SECOND FLOOR
1740
1740
COVERED ENTRY
26
26
DECK
55
55
GARAGE a CARPORT 0
674
674
OTHER (describe)
Area Totals
EXISTING
PROPOSED
4,008
TOTAL
4,00
**NEW HOMES ONLY"*
ESTIMATED SELLING PRICE $ 400,000.00
# OF BEDROOMS
6
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
NEW BUILDING
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application
0
S
RECEfVLO
FILEMAR 10 '2Q117
Lakehaven CITYNI DEVELOPMENT PME
COMMUNITY DEVEi.,O°HENT
5
WATER & SEWER DISTRICT
TIFICATE OF AVAILABIL.It
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@Lakehavern.org
This certificate is intended to provide the applicant, land 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, water service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permit SFR ❑ Building Permit MFR ❑ Building Permit -Other
❑ Subdivision ❑ Short Subdivision ❑ Binding Site Plan
❑ Rezone ❑ Boundary Line Adjustment
❑ Other (specify/describe)
Tax Parcel Number(s): 894/200120 Site Address: 21XX SW 344th PI Lakehaven GIS Grid: F-12
Ex. Bldg. Area to Remain: N/A sf New Bldg, Area Proposed: 3,138+/- to 3.9274-/ sf
Applicant's Name: 696 LLC
WATER SYSTEM INFORMATION
1. ❑ Water service can be provided by service connection to an existing " diameter water main that is approximately
feet from the site.
2. ® Water service for the site will require an improvement to Lakehaven's water distribution system of:
® a. 40+/- feet of 8" 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): Developer Extension Agreement required Extend to far edge(s) per Lakehaven policy.
3. ® a. The existing water system is in conformance with Lakehaven's Comprehensive Water System Pian.
❑ 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 easements) as required by Lakehaven;
® c. Other: Water Service Connection applications required Active DE Agreement (#2 above) must be accepted by
Lakehaven, prior to service connection activation(s).
Comments/special conditions:
The nearest fire hydrant is approximately 5+/- to 185+/- feet from the proposed plat lots (depending on how these distances are
measured, as shown on map on the back of this page).
See attached (pending) system hydraulic model results that will indicate at no less than 20 psi, what GPM figure Lakehaven's
maximum allowable liquid velocity of 10 ft/s is exceeded. Fire Flow at no less than 20 psi available within the water distribution
system is a minimum of 1,000 GPM (approximate) for two (2) hours or more. The attached (pending) system hydraulic model results
will depict the theoretical performance of the water distribution system under high demand conditions. Fire flow rates greater than
this may be accommodated through water distribution system improvements, contact Lakehaven for additional information.
538 Pressure Zone Est. Meter Elevations) -GIS: High 374+/-, Low 359+/- Est. Pressure Range at Meter(s) (psi): 62-77
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: DEVELOPMENT ENGINEERING SUPERVISOR
Signature: Date:
696 LLC wtr Eagle Manor 8947200120.docx (10/18/16) Page 1 of 2
ol,
2421039005
34249
Ex. So' Main -to
Main
(Active) SW 344TH ST (Active)
8947200130
80472 100
22 3
2
2: T F3 4 5
Tracctt B
B
Q) New H drant
Act' e)
New Boo Main
'New 4" Main
'-�Acb (Active --- 'K
Yet Co 1.
P
(Active)
- (Ac ve 6
N6V Yet Completed
Not Yet Com� e
7
CO
402 T 12 11 ALO
9574800014
34435
9574800015
FJ 0 TE: Lakehaven Water and Sewer
District neither vorrants nor guarantees
the accuracy of any facility information
prmided. Facility locations and conditions
are subject tofteld verification.
696 LLC wtr Eagle Manor 8947200120.docx (10/18/16)
8
Water Certificate of Availability
Parcel (original) 8947200120 - Eagle Manor
Feel 12/5/2016 BIA
Page 2 of 2
Lakehaven Water and Sewer District
Hydraulic Model Fire Flow Estimate
Request/Reporting Form
Requested By:
Eagle Manor
Date:
11/29/16
Location to be Modeled: 21 xx SW 344' PI (APN 8947200120)
Lakehaven 1/, Section Grid:
F/12
Intersection:
SW 344 PI & 22"d Ave SW —180 ft East
Add. Description:
See attached map
Pressure Zone: 538
Results By:
John BowmW4.A
Date:
12/15/16
Model Run No.:
Master Water System Model 2007.net
FF #331
Condition
Pressure (psi)
Flow (gpm)
Static
53
0
Fire Flow
20
2400
NOTES:
Lakehaven's adopted level of service goals for fire flow rates are 1000 gpm within single
family residential areas (including duplexes) and 2500 gpm for multi -family, commercial,
industrial areas.
Model results depict the theoretical performance of the water system under high demand
conditions and are not guaranteed to represent actual system performance. A design
professional should be consulted for site specific design purposes.
The calculated fire flow capacity in the above table is based on a currently available residual
system pressure of 20 psi at the location modeled. The model indicates that Lakehavcn's
standard maximum allowable velocity of 10 ft/s is exceeded at a fire flow rate above 1500
gpm. Fire flow capacities greater than 1500 gpm may be accommodated through water
system improvements.
121516FF 331 - Eagle Manor (Form Rev. 12/6/13)
(Active)
2421039005
34249
SW 344TH ST
r � �
B9472 0100 8947200130
22 3 �
v 1 2
} 3 5
ba
Tract B
z '`New H drant �•ti
z ` Act ve)
e 8"Main Z 0 , yew 4" Main Y
Clive) c Act3ve6
Nod Ye om late i ;Not Yet Con Pet`
7
894 20011 a 12
402 2 ' 11 10 9 _
h10TF: Lakehaven Water and Sews
District neither verrants nor guarantee
the accuracy of any facility informato
provided. Facility locations and condition
are subject tofieid verification.
8
9574800014
34435
9574600015
I [Jlm
Water Certificate of Availability
Parcel (original) 8947200120 - Eagle Manor
A 5J 7J
12/5/2016 BIA
696 LLC wtr Eagle Manor 8947200120.dccx (10/18/16) Page 2 of 2
Lakehaven
WATER & SEWER DISTRICT
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, land 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, sewer service based upon capacity &/or supply limitations
in Lakehaven's or Other Purveyor's system facilities.
Proposed Land Use: ® Building Permit -SFR ❑ Building Permit -MFR ❑ Building Permit -Other
❑ Subdivision ❑ Short Subdivision ❑ Binding Site Plan
❑ Rezone ❑ Boundary Line Adjustment
❑ Other (specify/describe)
Tax Parcel Number(s): 8947200120 Site Address: 21XX SW 344th PI Lakehaven GIS Grid: F-12
Ex. Bldg. Area to Remain: N/A sf New Bldg. Area Proposed: sf
Applicant's Name: 696 LLC
SEWER SYSTEM INFORMATION
1. ❑ Sewer service can be provided by service connection to an existing " diameter sewer main that is
Comments/special conditions:
I hereby certify that the above sewer system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY Title: DEVELOPMENT ENGINEERING SUPERVISOR
Signature:
Date:
696 LLC swr Eagle Manor 8947200120.docx (10/18/16) Page i of 2
approximately feet from the site and the sewer system has the capacity to serve the proposed land use.
2. ®
Sewer
service for the site will require an improvement to Lakehaven's sanitary sewer system of:
®
a.
65+/- feet of 8" diameter sewer main or trunk to reach the site; and/or
®
b.
The construction of a sanitary sewer collection system on the site; and/or
❑
c.
A major portion of Lakehaven's comprehensive wastewater system plan would need to be implemented and/or
constructed; and/or
®
d.
Other (describe): Developer Extension Agreement required. Extend to far edge(s) per Lakehaven policy.
3. ®
a.
The existing sewer system is in confonnance with Lakehaven's Comprehensive Wastewater System Plan.
❑
b.
The existing sewer system is not in conformance with Lakehaven's Comprehensive Wastewater 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 proposed site land use is within the corporate limits of Lakehaven Water & Sewer District, or has been granted
Boundary Review Board approval for extension of sewer service outside of Lakehaven's sewer service area.
❑
b.
Annexation or Boundary Review Board approval will be necessary to provide service.
5. Sewer 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: Sewer Service Connection Permits required. Active DE Agreement (#2 above) must be accepted by
Lakehaven, prior to service connection activation(s).
Comments/special conditions:
I hereby certify that the above sewer system information is true. This certification shall be valid for one (1) year from the date of
signature.
Name: BRIAN ASBURY Title: DEVELOPMENT ENGINEERING SUPERVISOR
Signature:
Date:
696 LLC swr Eagle Manor 8947200120.docx (10/18/16) Page i of 2
2421039005
34249
SW 344TH ST
II,
89472 01 I I 8947200130
22 3
5
Tract B
rNoty.eLCQm
8" Main c.. 8947200120 ! I CO
tive �I 6
feted7
894 200 11 I 10 g
40 I I t
9574800014
34435
9574800015
)TE: Lakehaven Water and Sevoer
strict neither %-%errants nor guarantees
e accuracy of any facility inforrmtion
raided. Facility locations and conditions
e subject to field verification.
696 LLC swr Eagle Manor 8947200120.docx (10/18/16)
Sewer Certificate of Availability
Parcel (original) 8947200120 - Eagle Manor
Feet 12/5/2016 BIA
Page 2 of 2
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