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SNOHOMISH <br /> COUNTY40k Water and Sewer Review Form <br /> 7207 HEALTH DEPARTMENT <br /> Fill out this form if you are connected to city water and/or sewer services or are planning on having an on-site <br /> septic system. <br /> Facility name: Revive Bowls <br /> Site address: 2831 W Marine View Dr <br /> City: Everett State: WA ZIP: 98201 <br /> Contact name: Trevor Liska Phone: 425.268.2844 <br /> Email: revivebowls@gmail.com <br /> Proposed number of seats: 22-28 <br /> ❑ Yes 0 No Are you a newly constructed facility? <br /> ❑ Yes 0 No Are you making changes to an existing facility? <br /> 0 Yes❑No Do you have an approved grease interceptor in your facility? <br /> Your local water/sewer district may require an approved grease interceptor to be installed in the facility. We <br /> recommend contacting your local water/sewer agency for information regarding grease interceptor installation. <br /> WATER SYSTEM <br /> This section should be completed by contacting your local public water system official (if different from sewer) and <br /> informing them of the scope of your project and proposed new facility address. If necessary, a letter of availability <br /> may be provided for new construction. <br /> Name of Public Water Utility Provider: City of Everett - Public Works <br /> Full Name of Water System Official: Charles LR Johnstone Phone: 425.257.8224 <br /> Signature of Water System Official: Date: <br /> WASTEWATER SYSTEM <br /> Which type of wastewater system will your facility be connected to? <br /> 0 Public Sewer System ❑ On-site Septic System (Initial) <br /> On the next page: <br /> Fill out the Public Sewer System section if you are planning on being connected to a public sewer system. <br /> Fill out the On-site Septic System section if you are planning on being connected to an on-site septic system. <br /> Environmental Health Division <br /> 3020 Rucker Avenue,Suite 104 ■ Everett, WA 98201-3900 ■ fax: 425.339.5254 ■ tel: 425.339.5250 <br />