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THE CITY OF EVERETTDate— <br />Sketch <br />of Proposed Sewer Connection for Duildmn Situated on Lot <br />Division or Addition <br />Licensee <br />Application and Connection <br />Remarks:- --� M -= <br />Depth of Sewer at Connection I <br />7 <br />1 t <br />1l.s�fl <br />r- <br />Connection made the day of 19- Examined and Approved by. <br />Sapt. of Stree!s and Sewers By - <br />By <br />B Inspector -- <br />