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_.Licensee <br />M <br />THE (..ITY OF EVERE". T <br />Sketch of Proposed Sewer Connection for Buiilding/Situated on Lot____ �_E_2_ <br />Division or Addition�n.� "A6 <br />Date— <br />Block— <br />No.— 1 0 : 0 c�'R Owned by----,t, <br />1 <br />Application and Connection by <br />Remarko: �U _ PQt*z?L 5%rY — -- <br />Depth of Sewer at Connection I I I <br />_L4, tAt ta. a- -- <br />Jonnection made the. __' —day of____. __ _19f0(o 4 . Examined and Approve�d! by__ <br />K i!,� City Engineer <br />t,�.� -Supt. of Streets and Sewers <br />�-r By__.. _ _. ri%!( By_.—_— - _ 7-r---_Inspector '2282 / ' —_ O' <br />