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� <br /> T��� GITY Q�Ii' E�TEl�.E'A'7' �� <br /> - r j _ <br /> Division or Addition_____ .�_ � ' <br /> ^ �Iding Situated on Lot----L__--a' --1 l_------------ Block--------- -�- ---------- <br /> Sketch of Pro osed Sewer Connect:cn ipr Bu / , ' ' , <br /> p � , /, <br /> , . . � _ <' <br /> � _ -G'�.{�__:._ - ` ' -------------- ----------------------- ---- <br /> . ---=�-'--�--- _�------'r-__ . - ---- <br /> : � � i i� / . � � �, <br /> ' ------ ti __ ,�`—" ' 3' -- = =----�------ �^` "_"----------- <br /> . No. ----�-�--`Q ��� ------- --Owned b ^-�J` � �_�, _-- � <br /> . � /; ^ <br /> Application and connection by___�r a___'•�)_�_1___N�1L.� _� _ Licensee <br /> �---- -- - <br /> ---------------------------------------------- <br /> Remazks -------------------------- ----------------- ----- -------------------------------------------------------- � <br /> Depth of Sewer at Conne�tion I I f I I � <br /> J I <br /> . I / , � <br /> .��3. `' A+1ti \�"���!� �'/.-y��l I <br /> Y f.. \ <br /> ,� �� - ` <br /> �� (`�1 <br /> � � L� <br /> I <br /> r_� _ _ _ - ----- -- -- <br /> . � <br /> x? <br /> ` �� ., <br /> �1J � <br /> i <br /> �,s <br /> � � <br /> � � � <br /> F; : <br /> � f-� �' I I , � . <br /> , ;..<..,._,.. <br /> Connectiom m�de the___�^__dny of___..-_'_________ 1�J1 'L. Examined and approved Uy�__ • ���- - .. ___ <br /> � -'' � yi7 �,------ ------- City�--- •neer <br /> , � 07G7�1 I� <br /> - Supt. of SLreets und Sewers gy��\�j�_�(�__�l ��'�-^�="_`'"" '�n <br /> ---------------'�-------------- <br /> By------------------�----------------�-Inspector ------------ ----------- <br />