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TH�' �ITY O� EilEt� rTT --��, <br /> Dnte <br /> � <br /> ' Skrtch of Proposed Sewer Connecuon for Building Situated on Lot '--_--_--__ Block�-`?A1 ' <br /> Division or Addicion / / � �r '! ' <br /> No.��.—L��/�') /�f.l/'Lf Owned by i�:; - _ ' <br /> Application and Connection by --�� % ' Licensee <br /> Remarks: - – —____ ' <br /> Dcpth of S:wcr a:Conncction � I I <br /> ��v. <br /> __-- I I <br /> �Le'(1� ��i%� /��i�/ I � I I <br /> /�> �"'. �r�-� t7 �C..� �i/7r' '�- <br /> / <br /> a�;��_^�j7ca�cJ ��r;� ._, <br /> /�i�t.C(.c f`�, �l �:�, I <br /> I � <br /> I ( I <br /> � <br /> ::, , � <br /> � I ;,- ' <br /> .�. � r. <br /> • � i ' i i <br /> . � � I <br /> , I ; <br /> . i _. ; ', <br /> ,�� , :7 .' � <br /> ---�I�— i r' <br /> � � �_�� I.� <br /> Connection msde the�'—day oE�__�-.--19_,�_. Esamined and Appcoved L•y_ _. ________.. ___. <br /> , on[,,;: ��., <br /> - -- � —_Supt.of S�rcets and Sc�vers Dy__ <br /> ._ _ _.___ - _ .___ <br /> '' 12 �U5 _ <br /> ; Dy__ __I_�L_��_. . '�__--_—Inspmcor . _ __. . _ _ _— _ . .___.--._— <br /> �:000xs e.:v.se n.H enav <br />