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'��3[E CI'��t' O�' �V�;I�.�T�i` . <br /> --- - - ---- - — Block�J__-- <br /> Skcich o( Proposed Sewer Connection �or Building Situated on Lot__ -�--- - y _ <br /> Divisior, or Acidition�- - -�— <br /> No.—.- - = i j -- '—=� Own� �- ---'- =L -`_ ` __ _ _ ensee <br /> ; � _�_Lic <br /> Application and coer,ection by__--.' , ' ' --=--`-��" � ' <br /> Remarks - ---- <br /> Depth of Sewer at Connection - i � �'-- � <br /> J <br /> __ _ - 'i -- ---- '---- - -- I <br /> � J <br /> ' I <br /> _��_ � , <br /> ,��r �.�51��.I./a ; _ .(\ I <br /> G„ � \ � <br /> q ;i 1,; — - L � I �. <br /> --� <br /> -- __�--=-_ .-, � I <br /> I <br /> < <br /> r.., <br /> 1 <br /> I � ��_ � �� ' ----I— <br /> _ I � � <br /> ' I I \ 1 � <br /> / ,� :\ f' ; �_..,{..t <br /> Connection made the � day of �' � 190�r Examined and approved by Gty,Engineer <br /> � �. <br /> i <br /> � ," , J' '�I Supt. oE Streets and Sewers02u�Q�-' By /-=� � ' " <br /> _---=---- , �` 7' <br /> � i � � ' __�n5�ectoC. --- — '- — ' <br /> BY------ --- ------ <br />