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. � i <br /> � <br /> EXHIBIT"A" I <br /> Attn.: Kirk Brooks <br /> City of Everett— Public Works <br /> � 3200 Cedar St. <br /> Everett, WA 98201 <br /> (425) 257-8810 <br /> Subject: (Address) <br /> onnection to Available Public ewer <br /> � <br /> My property is presently utilizing the following method for sanitary sewage disposal: I <br /> [ J Septic Tank System. � <br /> [ ] Connected to the Puh!;� Sanitary Sewer System. <br /> To the best of my knowledge, my existing septic tank system: <br /> [ ] Adequately functions. <br /> [ ] D�es not adequately function. <br /> I plan to do one of the following: <br /> [ ] Connect within 60 days. <br /> [ ] Request an extension for up to ten (10) years. <br /> Signed, <br /> 8� <br /> PROPERTY WNE PH E BER w <br /> �k F,",�! <br /> �,� � d�,�" <br /> �!N'S�� ' <br /> �� <br />