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" THE „1TY OF EVERL"rT t <br />Date_ <br />Sketch of Proposed Sewer Connection for Building Situated on Lot_1— Block— 674o, <br />Div;sion or Addition Z-21" I c <br />o <br />No. A— ?// &,ia.if SQ a — <br />� Owned by__�i <br />Applicatiort and Connection by 5L- fnW1& (, ,y fi [ a <br />Remarks: _ -/ - - - ---Licensee <br />- — <br />Depth of Sewer at Connection I <br />Connection made the_ OL clay�of <br />HY----C?------� - <br />r <br />I <br />'a G t � -.196 1 . Examined and Approved by_ /N/ 61O1«+ <br />.- Supt. of Slrocls no(d]Sewers Hy. <br />- Inspector <br />