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�'�iE ��'TY �F' EV�R�'Y'T <br /> Sketch o( Proposed Sewer Connec'ion Ior Building Situated on Lot___________ ____ Block ' � <br /> Division or Addition__ � <br /> --- <br /> No.----=-'-- � Owned b ,,, <br /> / y-- - -- -- - _ —�_�—_ <br /> Application and connection by —�` � , � __ <br /> � icensee <br /> Remarks__ <br /> De�th of Sewer at Connection I � � e <br /> J ; , <br /> -� - ---'- - ------- � <br /> � � <br /> � �� � � � <br /> � � <br /> � , . <br /> , ,, , , <br /> � � <br /> _ _ i � <br /> ; _ . . <br /> �-i- - ------�-- --- <br /> _ � _ �. <br /> ; - <br /> � <br /> _,_ I j ; <br /> I <br /> � <br /> � � _ � i <br /> --�-- - - - --------� <br /> , � � � 0 <br /> Connection made the_�day of , � ' '�' � '•'�_I90;r Examined and approved by <br /> City <br /> ,. t�,;.�('�},.,_ . _.. �235� Engmeer <br /> . <br /> �_,_Supt. o� Streets and Sewers. $y ` <br /> ! j'� � <br /> , � <br /> � � <br /> B3 —=__1__�____-:_- =---Ir.�,:�c`or. / <br />