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� <br />THE c,:ITY OF EVERE � T � <br />Date_ � �_ <br />"i� �' <br />Sxetch of Proposed S�we: Connection for Building Situated on Lot___ .r.l __ _ Block__ _�/7 ¢i= <br />Division or AddiGon__�_l{T/�'-Gfv�-��____ _ __ _ <br />�.y� v <br />No.—_�� �Nnivt.irGLlv- Q��Nc --Ownedby-- - �}�—�j��GI� ---- <br />� v <br />Application and Connecfion by <br />------- ---- — — -- — — <br />/�f �'� ?�"� /,;c nR3 <br />Aem�ka:_�_(L'�" d' -���• <br />DeptL ol SaR�er at Conneclton <br />`f-�� fJe-w,ti�c.�r;•,- � G'. <br />`'""' j�,�,t ��,.Q / 4- � � <br />� �.6,.. �tllLl..�' C_C7'1,WE.�.. ,� <br />J I �� A-u�.�c c� . <br />�I � <br />\�i,.i'J, Cs-u.��,kf� /�-��-<-� <br />—_Licensee <br />�-�-�-�- te± i�..o-�z ct,,.<.�=�...., <br />; I f.:-�-�t. /L�.wa� ��y I�i.�., �i,.Hu.,,� <br />Pd cT�G <br />� �y ~ - <br />'� 1/� � <br />Connection made the_ � � �-__day of_ �t�w-'Y <br />� �� <br />� <br />/ I � <br />6 4 �? 1%� (�G�-uL=�- <br />_19_. Examined and Approved by__ <br />.., City Engineer <br />_._ ___ _. ._ __ __ <br />�____—_ ._ Supt. ol Slreets and Sewere By___—__� %� ' r�� <br />/ <br />By_ __ _'._ `_ `.. _�-. _ _' _ . __ .._. ___Inepoclar 22180 <br />