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� / <br /> �. <br /> ,/ e � 'l•��+�� �, ��1 � ���� �� � i/ �[ZL� ! Date _... r .it=� v <br /> 1'� / �/-�- " <br /> Sketch oE Proposed Sewer Cunnection for Buildin� Situated on Lot-f.�-�---�.Sr_�I_ Block--�-_�Q - <br /> �„� -'t'�-/ '-•7 <br /> Division or Addidon �[t-E 1L—__�lr-__ l t c�a _ __ <br /> No.��.-%,� `^ � ?� � ` 1 <br /> --`�.�- ' w --Owned by-�os,,a...-��1-#� '4�r'(--- <br /> ..+.A"' � -'' <br /> Application and Connection by ��-�--GL_��__ — Licensee <br /> Remarks: ----_-_------ <br /> Depth of Se�x•er at Connection I ( I I <br /> I <br /> ____ _ ____ ' . _.___" _. ._ _ .___ --- ] /� I <br /> �I ��`' •'�v!- � � Li.`�2-/ --_ ----i— <br /> I <br /> �` .,�. <br /> c,, � �-, <br /> , -- — � <br /> - � —�6 �— <br /> — \ ��L'i i <br /> �.� ; � � � <br /> —� \` \ L� <br /> I � �i <br /> / ��.�7 --- <br /> -_._I--_. L G'c.< A P C� I <br /> � � � <br /> � �, ,�e ] 1. i <<� r �f� ) ��� <br /> Connection m�de the___l__dny of ______19�. Escmined nnd Approved Uy�`L ,v�-•.��-�,,��p <br /> � --.)�� c��ve�a1��— <br /> __ _ $upt.of Screets nnd Sewers By G_y��_IL/ ___ <br /> � <br /> i <br /> �Y � ' .__ r 1_ � _Inspecmr � <br />