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THE CI 1"Y 01= EVE�FT . `
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<br />Date_�__ -`--- i, c--
<br />Sketch o; Propo�ed Sewer Connoction to: Building Situated on Lot �`�
<br />Block ��
<br />Divieion or A9ditiotL i.�- �- �' � --- ----
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<br />•- - -- -" - - J. f .-_ 11. _. --�- - -Owned by � _ �� . �--_ /�� `.+ � '�, i�/
<br />Applicatinn and Connec8on by_ _ ______rl_} ' _ _
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<br />Conneaion made Ihe �� ��' day ol '' j�+ . s . 19 �'. Examinec and A oroved b
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<br />-- - •- `��� ; ' Sup1. ol Slroeb and Sewa ' � � - �? __City Enqineer
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