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821 109TH ST SE 2016-01-01 MF Import
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821
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821 109TH ST SE 2016-01-01 MF Import
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Last modified
4/14/2017 5:06:47 PM
Creation date
4/14/2017 5:06:46 PM
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Address Document
Street Name
109TH ST SE
Street Number
821
Imported From Microfiche
Yes
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�E�t:.�vr••° <br /> , ., , ��os <br /> �� EXHIBIT "B" <br /> MA NT��A ,,E <br /> Attn.: Michael Papa, Engineering Technician <br /> City of Everett— Fublic Wurks <br /> 3200 Cedar St. <br /> Everett, WA 982J1 <br /> (425) 257-8810 <br /> Subject 9,a �_ i p� �}-. SE � _Fverc-f-1- �.�A (Address) <br /> C�nnection to Available ublic Sew����r�� <br /> My property ut�lizes the following method for sanitary sewage disposal: <br /> [ ) Septic Tank System. <br /> � Connected to the public sanitary sewer system (show proof or <br /> arrange dye test). , <br /> � M1°Le-' �ta�ce� �P �^Cm' CNI�$� <br /> To the best of �ny knowledge, my septic tank system: <br /> �Q Adequately functions. <br /> [ ) Does not adequately function. <br /> I plan to, if I am not already connected to the sewer: <br /> � ) To connect within 60 days. <br /> or <br /> [ ) I hereby request an extension for up to 10 years. <br />' Signed, � <br /> (L�U �/ 1�J �/a5-355-y.SCo3 <br /> PR PERTY OWNER PHONE NUMBER <br />
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