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Tf-i� �ITY OF EVEI�E�fT <br /> Date --- <br /> `':�h ot Pro � <br /> Pused Sewer Connection for Buildin6 Situated on Lot _ __- - Block_ — <br /> �'��:on or Addition - ----- _ __ - - - - <br /> / / - —_------ <br /> ` �I �-f"j!�'L�-�.� ' - - - y '---- � <br /> — Otvned by__ �"�'-�--"-� <br /> ,::, �� !� -- _ ___ _ _� <br /> ��r �ation and Connection by__ __ _.__________ __ _ _Licensee <br /> R'acrks: _ —�f-------- <br /> �.::'Sewec at Connection � � `--- '. , --------- I I <br /> � L.�_ <br /> - - --— �---- -- � I <br /> r�;'�r.�. i � I i <br /> 1 <br /> —'_ �Y�� <br /> � ' � � <br /> � ; <br /> i i <br /> J <br /> � � <br /> � <br /> � <br /> .. _'�__ —_ -- . ____ I. <br /> .__'_. _' —_— <br /> � —___.—... <br /> � I �� � <br /> � . OG�4u � � <br /> C�n����fon mode the�—' '--daY of 192_. Lxamined nnd Approved by_ __ <br /> City Cn i _._ <br /> . -----_� Nupt. of £treets and Sewers. pY cl:eer <br /> _�_� . f ----_ <br /> � �_ _Inspecror. - � ` <br /> � �_ <br />