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� —Z <br />.. . —1� I< THE �CI�'l' 0���.'i s �, <br />�E ERET <br />�� <br />Date ✓'' 1%_ /'!ir Y <br />Skotch of Proposed Sewer Connection for Duilding Situated on Lot__ �' _���� <br />�' ---� ������ <br />Division or Additio� _ �'� '.1'r�� �^ _��'��_ ��''„M�•' 7'�' !J/U' /Block "' <br />/� I i �,.�` <br />No..l�� � � .;: p`.� .-, C ' Owned by_ J�j/�1 /�-.�T__=d!✓ .a rd :� `fl��—��NL_ <br />Application and Connec6on by � _ L�,� � [..! %`/ � ; '7/��,[ <br />Rem�ks: �..."^-�4�,..., iF-1 � ? '�� `-� R.% _—Rec. #�! v;��� . <br />Doplh o! Suwor al Cowec(Ion I � ' - I � <br />�Iwu�axcciLf�. ��'� � 9'0l�'' ���., c,u� <br />� � Cclt,u. �4� 10 �-�.(�lM.�iiw Q� � <br />w P�, 9Y=' %�e�- ��--. <br />G•• �xc, ✓.s.��{�. �:a.. ,,�.�.,._ <br />�f �� R.b. V S�:�c, inc-w-�s. fo. �(+..[Au;q <br />t�+-�.� � ' / .� <br />�".�w..4. Zst_PcG.{+.cn�, Eue,vNu,,, ll1e.� <br />��,,,.,.. S��xw.�., s�.:�.�.. � n E c� <br />c� 'n�l. �d...r.A�--r. 8/� �.Fs,.�., <br />G'�9�-w. f Y���...i.e� � �' � 7)oitL �— <br />A.�.CL. o-� L4L� LyAt.uuun.. ���. w.r' ��J. <br />�"R�k1. d s P�, �. � z' iw t.� �n w. ,;,�, <br />�� ��{�n±�u+c,' ,�,i,k,A�.:,1 C.�k..e QF: %/xo. <br />� 1 . ,.: f �;:7,, � ^,'E� 1 <br />� "1�"/ • L l <br />Connection made ihe. ______day of_ __ <br />By—_'_ <br />--- 19_. Examined and Approved by �� �~ fl ��� �-y,L_ <br />1 � ^ Ci.ry Engincer <br />_Supt. oi Stmote and Sewers By__:.,_ ��J�._��..�� <br />wr.. <br />'p°"°' 30J29 � __ <br />