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�"1-I � C�l'�° O� E'�/E R ETT - <br /> .�. <br /> Datc-._ .___ :�" .. -_'-' <br /> Sketch of Proposed Sewer Connection for Iluilding Situated on Lot---�-�'_ __.__�rr'__. Black--�—�___ � <br /> Division or Addition � � __ _ __ _ <br /> �._�y� /; � r <br /> No.---- -f. Ownedby-'—=-1`�'---� <br /> � �%�i��`_�-�`�— —--- - -- - -- <br /> Application nnd Conuection by - -' � " � ___________________ Licensee <br /> ----- - --' ,_ _ -- �- <br /> ,� <br /> Remarks: --- ____ _ ____ <br /> - - _ —_ _ _ _ — <br /> Depth of Sewer u[Connection t I � . I I <br /> _—._..__._ _--. ''I ' . I <br /> _ -- . <br /> I ___—.._-____�`--_ — .--_.._I_— <br /> � � ; ��� <br /> J � i <br /> L r' In , � i,.. t y,.:t;. ' ! <br /> ' ' <br /> �, � <br /> � I _� . . .1 ;: .. ., ; .� ; <br /> , , � ; <br /> - I ,i/ _- �� - -- -- '� <br /> � � <br /> i� � <br /> l <br /> ' I <br /> . <br /> , <br /> --- -------- - . <br /> i -�---�,� - <br /> . . - --- ---I -- <br /> I �� � � <br /> � �} 11_ iU�t <br /> Connectiom m�de the_pZ �_day of__r� 19'1 3� Exumined .ind Approved by________ <br /> �--- . c��ri�a��:�� <br /> ____Sapt.of Streets und Scaers $ ' � <br /> Y_______. ____ �/ <br /> � � — <br /> By _ Inspector <br />