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EXHIBIT "A" <br /> Attn.: Kirk Brooks <br /> City of Everett— Public Works <br /> 3200 Cedar St. <br /> Everett, WA 98201 <br /> (425) 257-8810 <br /> Subject: I«��2.�' � S� ���� �(dd� <br /> onnection to vai a ublic ewer <br /> My property is presently utilizing the following method for sanitary sewage disposal: <br /> � Septic Tan� System. <br /> [ ] Connected to the Public Sanitary Sewer System. <br /> To the best of my knowledge, my existing septic tank system: <br /> � Adequately functions. <br /> [ � Ooes not adequately function. <br /> I plan to do one �f the follo�ving: <br /> [ ] Connect�vithin 60 days. <br /> � Request an extension for up to ten (10) years. (p MO✓1Tr�� � � (,� , <br /> ..-----E►--- <br /> Signed <br /> . . C42s)��-��35 e�,( <br /> �4z5 3s3 2« �f,�c <br /> P OPERTY WNER H NE NUMBER <br />