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THE CITY OF EVERE'i T <br />Date r= j- r j <br />Sketch of Proposed Sewer Connection for Building Situated on Lot._. —_--_. Block—_ <br />Dit;taon or Addition <br />No_ — —Owned by-- <br />Application and ConnecCon by- —.— C, 00, %mac yvi, / �/• a�ur 7` s• rlo.'I _-Mcensee <br />Remarks:__ <br />Depth of Sewer at Connection <br />C, <br />I <br />V <br />e �� fit: t•�' <br />Connection made lhe_ , i dap of —mot - 19.__ Examined and Approved by_ _ / • jel <br />/ City Engineer <br />Sort. of Strnets and Sewers By — <br />By —_Inepsdor ._ <br />'�w cn[ a NNCer al..Wow <br />ham <br />Sr eu3K �MWrt <br />