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'lf"HIE C1T�( OF' EVER� :TT � <br />--- , � ��� � <br />. - �: C- � f n JN riS Date / •�' :1_�• . <br />� i'„- �: f. ,. ��.-N.- �-�; <br />Skelcl� of; P:oposed Sewer Connection for B:rilding Situated on Lot.__--=------ Block '-_ ' - <br />� ,� [_ , i .�, i� � �'. �I. f <br />�,r;:x,;-.. �,a.;;,_J,ru%i�.a r� s -- <br />Division or Addition �_.—'----- �i , <br />7: —Owned by_._ � r ! � :.,/ T .�'1; ��• <br />� •:c-. . ----- ---- <br />No.— -- I-'--^ .''.—_ _ <br />�� ,-� ; � <br />�7 , . � ,. � .;,:: /�� � --- - -- <br />Apolication and ConnecGon by___ � — -- <br />-. . - � <br />. ,, > • _ ,; � 1 : �. ; f �r: ! < � <br />: � <br />.. - .. . �.- ,. • <br />Rema:ks:_ - � --� ---- !- ------ � - - -- - - - - ----- <br />Pepth of Sawor al ComecLLcn I I - � <br />�S <br />,, , :, <br />i P_.�t:•.«<_.r-�.�_�_ t� ,� <br />,�y;�.u��._�_� �.e- �-�.�L�4 tr <br />�� . <br />�,' �Z ,�1. �., �.k_, �.,�.� <br />J � <br />Ir, `N-�:.�� cl�t,.t.. - <br />__ Licensee <br />✓ � <br />� <br />, <br />-. , i , <br />Conm�ction made the_ ��' -__day oi ��/i-�-�t�"-'-t __19�. Examined and Approved hy___r.-�---- �--- <br />/ ` --f . ---- �— . City £ngincm <br />f / �' <br />__�/�Lc����-�_,'(�� __�G7C'__�upl, o! 4tcaele and Sewers BY------�-----� —�------ <br />By —.___ 1 \ � �--�-- '�-f—�3 —__InePecloc 1 U `Y � J <br />��-. ..,� . ,,..�., <o . <br />