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,/ <br />THE G. TY OF' �VERE? �' ��� ���G � <br />W / i�/ �� � .�i'���- Date— <br />Skotc}i oi Proposeu Sewer Connection hr Building SiWated on 7.01 ys . _- Block- -/7 /'Q�� �—.-- <br />Divlsiou or Addition_ __ ��{ f!lfi3i�e� J�r�� -- j — <br />No.__ �//�_—��e✓ii�__ L�4.ih-- - --- Owr.edby �/I.s/,.� �N��n -- - -- <br />� �i,�/-_J/ <br />Applicalion ond Connection by---' `�- r�-^�'tl'� --- _ _ _ _ __ _ Licensee <br />r �,�. �� � <br />G -- _ r�-�__IL•Z�S--- - - - ---- -- - - <br />Remcsske:— �..--- — _ <br />Drplh ol fc�ir. al Comecll�,n I � I � <br />J <br />�f„ , ,..,.,.�, . .�._ (,� �, <br />„ <br />i v e�, ,. � C. �. o.-. a: ( �:a'.:.. V. <br />��,.�.e��it �Ci� �'.i �.c.. .5 .l .1�..� <br />,,�ti\�4tL � <br />��„�J�'..IJ. t°o�.��.:Ct_ ,..:c.,, <br />,� / t (� <br />.l�t[. (,D .y�PIILG i\/i1�.._... <br />,�'j(. <br />1 <br />Y• <br />IV <br />j <br />I <br />. � �- ! � <br />• t �,(� /� ' <br />Connectiai made thy y t� _ _day o(- _' _ f r�' ° ` � 19 �'_�'- _. Examinad and Approved by_ - —✓l•—v- [ ��v� �'- _ <br />ity Enqinoe� <br />�1 `f; f"�= <br />_ __ __'. _� C s� r� . �. . �� i�. _ . _ Supt. ol Sl�oela and Sewon HY -� - - ---� ' -- <br />a� `l�\r,Y.�O.<i� Inepocln� �O� ! O ' _—_'—__'__'— <br />