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/'� �.�. <br /> I ( <br /> , Sewer Stub Information Sheet r, � � � 0 �� n <br /> I. NAME F ��"��p� J MYS2 k�W SKI L� i IJ <br /> F::3 1� ��as <br /> 2. ADDRESS I 15 /9f� AV� 5.6. <br /> ........, <br /> _ ................................... <br /> )' � � � � � ��� �C�T`./ Or E`JEREl i <br /> 3. TELEPH E ���'1 `^%' �� , �� �' �� .5~� - <br /> � � � <br /> �4'�.1.�, v1�.:�{($ C'C:. <br /> 4. Show pertinent existing structures, patia's, driveways etc., in ihe <br /> sketch below. <br /> 5. Show location of septic tank and drain field. �„� oF i <br /> 6. Show desired locafion of sewer stub. I <br /> 7. Future plans for my property a�e: everett <br /> ^UBLiCwOa+50Eo�A1ME'It ' <br /> l:.o CE��4 5*aE e� <br /> EYEAEtT w�5wir�GTO�+ <br /> 92:0� <br /> 8. Please send me the details of how we can utilize the local <br /> Improvement District assessment process to finance the cost of <br /> ihe connection fees and the cost of conshucting the side sewer <br /> from ihe structure to ihe sewer stub at my property line. <br /> CHECK ONE ❑ YES �NO <br /> i <br /> � '� //zis <br /> \j �, <br /> � <br /> .._..1�Gii�/T:.�.� I . <br /> r�' 'O I <br /> '� , �t,r,�l ' �tR�lc.To r- <br /> � -rA.✓K.% � i : <br /> � �I r � � � ' ��� J£G�At1� <br /> I � `� . \ , <br /> li • r � . , � <br /> li ' j Dea.�. <br /> �I .i r"`� - <br /> i ' '- � : <br /> �G�/�YD-► $')4 a 4 .—_� P <br /> 6 <br /> /9� Av� sE. ; <br /> �— - - - — - � � <br /> r <br />