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��� �i� i � ��' !LS �/ ����� <br /> Sketch of Proposed Scwer Connection Eor Building Situa�ed on Lot__ Block <br /> Livismn or .'lddition__ _ - <br /> No.-- ; � — _ Owned by----- —-- <br /> -- _ —_ <br /> Application and connection by_— �.icensee <br /> Remarks __.-- _ <br /> Depth of Sewer at Connection � 1 � a � ! <br /> � 1� <br /> -- _ _ - <br /> � <br /> i I <br /> - . _- - ----�_ <br /> I -- � _� <br /> _ -�— -- ---- --- . - _---- --� <br /> J � _� _ � <br /> � � <br /> � I I I <br /> Connection made the - _d1y of � 190 :' Examined ancl approved by— <br /> ' City Engineer <br /> _ _____ .__�_~�upt. of Streets and Se wers. �`�'a 1 y BY <br /> $ ' , '" Inspector. ------ — <br /> y_�.�--- ----=-- _ <br />