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I����o��D <br /> JAN 2 2 2001 <br /> Attn.: Micliael Papa <br /> City of Everett — Public Works ��AT(QNS,� <br /> 3200 Cedar St. �NT��WCB <br /> Everett, WA 98201 <br /> (425) 257-8810 <br /> � � � s , SE ��G7� i% `�d'2°�� � <br /> Subiect 7� � � � � (Address) <br /> Connection to Available Pu�lic Sewer <br /> A�y property is presently utilizing the following method for sanitary sewage disposal: <br /> [� Septic Tank System. <br /> � ) Connected to the Public Sanitary Sewer System (show proo(or <br /> arrange dye test). <br /> To tlie best of my knowledge, my existing septic tank system: <br /> (Q Adequately functions. <br /> ( ] Does not adequately function. <br /> I plan to, if I am nol already connected to the sewer: <br /> j� To connect within GO days. <br /> or <br /> ( ] I hereby reyuest an exlens�on for up to ten (10) years. <br /> (atlach 5nohomish Heallh District certification) <br /> Signed, <br /> ��7-�-F.��-�- ' ;�,;) ;�7 � °I �� <br /> PROP OWNER PHO!J[ NUMBER <br />