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I. NAME <br />2. ADDRE <br />3. <br />4. <br />6. <br />7. <br />� <br />Sewer Stub <br />Info�mation��Sheet �� <br />.....,_ _._.._..._ c�c: otl �n . <br />�. <br />���,- <br />. .. . . ..__., _ � �� � <br />TELEPHONE <br />Show pertinent existing structures� patios, driveways eTc.� in ihe <br />sketch below. 1 n� � n� n�; � D <br />Show location of septic tank and drain field. � �� �� 1�1 <br />Show desired location of sewer stub. Lll <br />Future plans for my property are� ��� ��QB� <br />. ,.� . . .,. ... .. . __ _. _ . M. � ... . <br />CITY OF EVERF:TT <br />c .�c or s eT <br />Please send me ihe details of how we can utilize the locol <br />Improvement Disirict ossessment process io finance the cost of <br />ihe connec!ion fees and the cost of consiructing the side sewer <br />from ihe structure to the sewer stub at my property Iine. <br />CHECK ONE []�YES ❑ NO <br />_ _._ ... <br />�— __ ��..�� ' ._ ,_ �� �. Y.N � �.' <br />. yM�1C �\+0'n��1\`�'tt%� <br />'1 <br />22tR—t1a� � <br />------� � ...�.r ? I • <br />I � <br />� � <br />1 <br />I � <br />i � �Y� c w. <br />j' i o..:... c,.y <br />i I � <br />I t — 23.1-�1�� <br />�. � — <br />v � � <br />d ( ► <br />► <br />� <br />a � it.(T:c � <br />� � On.st.i <br />r �Eul1. F:,_u <br />♦ t�.4 <br />tlTY OF <br />everett <br />PIIBL iC wOARS OEP�PtuE M <br />]}pp CEO�P SiPEEI <br />EVEMfR W�SMiMGTCN <br />aevm <br />IL/i sE :/�L �•o sF �PE.fjo�•vD te /TEti1 8. ABovE 9•VD <br />�QETvR�I /IV Ti%E E�!/�YOSE�D StAMPEO EM/E�aPE <br />