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THE G� TY OF �VER�T : � <br />,, <br />Date " � " . <br />Skelch of Propoaed Sewer Connection for Buil�ling Situated on Lol_.__� i� /-- ------ Block-- _�./ V�—_—__ <br />- �� i ;� f� . <br />Division or Addi4o� _� r'�r. -� --��-- � � r: ' i�o ���,-- -- �— -- <br />j� ' • ,� ; <br />No.--u, � � �� 1�C-0 G:'�_ �' -`�"� --Owned by--�'� �,r �±'��� n-- - -- - ---- <br />. „ <br />---- <br />Appliwtiott and Connection by �y • :.. ��/. _'r/- _. _._-------. .._ - -- -- --- . - -- - _ Lica�ee <br />Remmka:- -! .� �=�-,!---f '': �: ��. �� G.-6 - — _ _ - - - ��C•L�� G n•Zl�r. m-- <br />D..p•1. ul S��ie� al Connxllon ��� I I � <br />V� /1 <br />� � ��Q'�/:��V ✓ — � — <br />Co�.:.����--...._ 1.�.��.�. G., �t� <br />, ,— <br />:ma�... �7�/ , �ibltk D�. b�2:�. <br />it'.tt-� ;yni-:t�+�f�. Ct-u.e�.. � �,,d„ <br />���L,,,,- ;.^�.',;..zr ,�'c.�.tt, , <br />, <br />l� � P , h. �euv�.��, .,u...�� �... (-.: <br />�� ,��i �.wt� .�.1;, � <br />4" r1,�"" C.MWk.:v 'r+t..ti... <br />if hr-u_ti d L4a..... <br />��° � �"� �lUz <br />Connection made lhe. �� = .day ot <br />j � <br />�c"� r-�.� ,�-t-L� c.'i`-. <br />--- ,_„d <br />By _ _ _ _ <br />-..( '.�`Jp.ticc�. <br />...�t'�.:.--, <br />�i`'i <br />:i°�dPA:.. <br />G � �"�. i� ���I✓,�-/ <br />� 7 � ° �"� _ _ _ _ .19 _—_. Examined and Approved by_ - - - � - <br />♦ .' �/�, r.�- City Engincet <br />. .. Sup1. ol Slmot� and Seweu H}• . /�v/l��-.`-.[.1• •''=�.��' <br />InePocloc 1 :7 � � lJ - _ _ _. _ — — _ _. _. — _ __ _—_ <br />