2010-01-27 HEX #10-001 Exhibit Ja.:• Web date: 04/26/2007 /
g, -.SEWER AVAILABUTY:
prty I❑� �g ING COUNTY GER�"tFICATE OF
Department of Development and Envitlb�jfa�}'s
Bullding Services Division - SEWER AVAi>(�AI UTY ERU�
900 Oakesdale Avenue Southwest CITY OF FEDERAL WAY -
Renton, Washington 98057-5212 CDS For alternate formats, call ���2g-5fipp.Y
2ns--296-6600 m 206-296-7217
This certificate provides the Public Health - Seattle & King County Department and the Department of
Development and Environmental Services with information necessary to evaluate development proposals.
Do not write in this box
Name
❑ Building Permit Preliminary Plat or PUD
❑ Short Subdivision ❑ Rezone or other:
Applicant's name:
Proposed use:
Location (attach map and legal description if necessary):
1. ❑ a. Sewer servicecan be provided by side sewer connection only to an existing size sewer
OR feet from the site and the sewer system has the capacity to serve the proposed use.
b. Sewer service will require an improvement to the sewer system of:
'(1) ±
feet of sewer trunk or lateral to reach the site; andE
,K(2) The construction of a collection system on the site; and/or
❑ (3) Other (describe): — '�---
2. a. OR The sewer system improvement is in conformance with a County approved sewer comprehensive plan. Y
-
❑ b. The sewer system improvement will require a sewer comprehensive plan amendment.
3. X 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.
❑ b. Annexation or Boundary Review Board (BRB) approval will be necessary to provide service.
4. Service is subject to the following:
a. Connection charge: p l4 CPtL�U L
b. Easement(s): S L]
C. Other: tr, ,.] 7 u �. � ✓
e tS7 SIEL.y r.[Z 1C� ��.f �—f-i �t.l rVl ► l� e `4 , Pc �i1
k The District, at its sole discretion, reserves the right to delay or deny sewer 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
Agency name
Title
sewer availability form.doc
Vu P-Y
ignatory name
Signature
b-cert-sewer.pdf 02-07-2002
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