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l <br />THE C i rY OF EVERE-1 <br />Date —�:t3_. A /I/ 6 4 <br />Sketch of Proposed Sewer Connection for Building Situated on Lot__ i/ 6 Block___-// <br />Division or Addition 44 U ,IZ E e- h'E/G ems_ <br />No.L b (3—p _p __Owned by-xj c- <br />Application and Connection by- L . �� fl G (L. __—Liconsee <br />Remarks:-1 O C f? M t T <br />Depth of Sewer at Comection I <br />• I <br />Cw.M. ett a t <br />5904 <br />a <br />3 <br />Connection made the. 4Nu --dap of­-��-- 19 L � . Examined and Approved by 2 U C. O C. V / 4/ <br />CI Engineer <br />— at street. aad sewer. <br />,ir -- it - --Inspector 21310 <br />