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EXHIBIT"A" <br /> Attn.: Kirk Brooks <br /> City of Everett—Public Works <br /> 3200 Cedar St. <br /> Everett, WA 982U1 <br /> (425) 257-8810 <br /> Subject: J6/S - �ea,/S rs� (Address) <br /> onnection to vai a e u ic ewer <br /> My property is presently utilizing the following method for sanitary sewage disposal: <br /> � Septic Tank System. <br /> [] Connected fo the Public 5anitary Sewer System. <br /> To the best of my knowledge, my existing septic tank system: <br /> � Adequately functions. <br /> [ ] Does 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 /> '"� ' GN�7 Y.7��� <br /> �� �� �o�a�� ��.yo ,�,, <br /> � <br /> ,..1�� /9��', f� ,cle�r; � �.s�'�Q.�, <br /> e-Q-� oo-.—� �+-Q-4'.r�es 6� al�o � CG.� <br /> b� J `^�'� .�/i� � � ' � <br />