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THE �G. rY C�F E�,/E�I�ET ,' ✓ <br />Date� �� /1 v G �=z <br />Sketch of Prcpried Sewe: �'onnection for Building Situated on Lot --- _ Block �_ �1_�_ __ <br />Divlaion or Addiuon_ __f_'h_: '.��.k --_ _�-��'----- - <br />-- - - — - --- <br />No._ _ - -- - —= '--- �- i� 7 -Owned by F..' I.�i i_: �7 � <br />-- - - -"'-- - -- - - - i� � � �N _ <br />App:ication and ConnecUon by- - -- _-� ��'�_ � _-- _ __ � : ` _ 1 ' , . _ Licensee <br />Rem�ke;-- �- � . � �- - -� l_ �� /19 � T � ' / f l � f� <br />Dep16 0l :a�er at ConnMloa —_ . -.-4.�[ .�_ � <br />•'� � " � /� ' /1�� ~ `� <br />I •��� <br />— '. —__.____ �' ' <br />„ ,. �-_ I <br />�l C au..�t.t��o�-�- f'r �C --- � ---- - ----- _— -- <br />,� �lt�..�i.e,.,- aT ��-:.�r.4. --�-- <br />1- � <br />ti.e�a-•,�y ILu,.c- !r .C•�co«— 1, i <br />� � <br />f'..��'t�-a-c,t,: f�. " �.� � <br />K,%7 . Crw �u: � <br />C�i_:�. 4`' ` / '- — <br />, . -----� _ <br />.. _ i� D t�1'. . . , <br />�' � /, <br />, <<��r,, .��r � , , � <br />( �. <br />;- f-E ` <br />, � -- <br />� �� <br />Connection mado Ihe :� � day ot <br />_ ._ . ..�. � .- . , . . . . { <br />By ��' � <br />.. L i <br />I <br />' 19 _. Er.amined and Approved by k�, _�J_�U L U/ ti% <br />(- Clty Cnqlneer <br />Sup1. ol Streoin a�,�l .`.iwou By �L L%� �.1� ' J�/.,`__� <br />Ir.epeclo� � V � ( J <br />