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�.�i�g'. ������ �� ��iT��i���,.�, <br />. � <br />� , �� ------------ sio��t--------'-------- ------ <br />Slcetch of Proposed Sewer Connection for Building Situated on o_________- <br />- -- <br />� ------------------------------------- <br />--------- --- �---'--------------- <br />Div;sion or•-Additidn_____--------------- : , <br />-- � ,. .. -r=�----------Owned by --=_----=--'-----�—= -�"--=---- ==------ <br />No. -------/--(� (� <br />-- 1 ---------------=---'=---- <br />�a,� C t '� ~ ---`--"--------- <br />1 t.. ,. __, <br />Applicntion onnea ion by-------------- ------------------------------------------- <br />-f- . • -.. _ i . <br />� , �. . .,. _ � __ _ :�. <br />Remarks --=-==�`-------=------------- -----"-- — --------------------------- <br />Depth of Sewer at Connection I <br />!� ` <br />-;__ , � I, � <br />-- -- <br />_ - -- - � <br />Licensee <br />�i <br />, ,, - -� <br />.� <br />� � �.-� <br />,, . - <br />Connectionmadethe____�,___dayof______�___C_____-191.� Examined and Approveci by__._------------------------- <br />-- - <br />' ' _________Supt. of Streets and Sewers Qe�$t�, CityEngineer. <br />Br , � , . ---Inspector. B9- -------------'.`--=----�-------__--- <br />Y- ---------`�-----==------�--- <br />