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THE ITY OF EVERE . T <br />.> Date <br />Sketch of Proposed Sewer Connection for Building Situated cn Lot._._ — __ _ Block <br />Division or Addition_. __ �i t' ✓�C�6'.l !/7r�r rp /i fS <br />% e � -14 `* "% _Owned by : ,1, i/ � y i f tC G /� No.. 1 r <br />59 Z / e . c-v a T -j c4, en 1 C 'oar S C' ., _Licensee <br />Application and o1nnecti by { t <br />Remarks:- - _ )� l A Ir t }.t' � ty i s ✓ d i 4 f1 �+�2 YJet ( Cs <br />Depth of Sewer at Connection <br />A{� <br />rl <br />IN <br />Connection made the1T day of 19G Q Examined and Approved by_ <br />` { City Euffiaeer <br />_._ -SupL of Streefe and Sewen By <br />a <br />_luepwor .1 r.--_--- <br />