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� V. <br />i"�-IE C.,T'Y OF' �VEFZEI i � <br />Da�e� /I u c� �2� <br />Skelch of Proposed Sewer Connection for Building Situated on Lot__r� __y %__ _. Block��j+��___ <br />Division or Addition��e E- ✓�.:—��' 5.�-�! _7 '= /� �= rl �� S�-_--� f1 C � <br />rro.—'7/ G� t n u� �,� �<:. i,-a ��' k' r� oWnea by_-_lL1V_Q- --D_Gg�. �— --- <br />Application and Connection by �-- � C �"� :� �3 <1 C i� _ ______—_______.____ ___Licensee <br />Rem�ks:— �'_� :'- - <br />/ 0 C, r M 1-��� �?�-�- ---- <br />Dnpth o( Sevios al ConnecUun <br />`"./�/� � r ( �' , i � : �� %l <br />,� ,. <br />; �/" C F-yt,�uc�T.t%� �c 6 , <br />'�� CS.d.� (�-lG'%,+-F.tX'�, 1Q, <br />U <br />.�..L M:;" !d-.L�,L�c.t� <br />V <br />�,�' UZ ..ki. '�c .�.a-�:.0 d <br />� �-�� i` �l,d.t.,bct�' � l�il ao <br />',, (}�-�.-�. ��� VV 2 L�' 6� S Al <br />�. l�Y�4.un. 1'lLJ1�-w-.G. <br />D <br />�.,�.���,'. `f l ; �.�t. <br />/ �i l / <br />Connection made the. ��_day of_. ��-S.t�S��_---19 b'✓. Examined and Approved by___� �-• � L� I�`� <br />, �l (7 ^) ^ Cit Englneer <br />__ �'�"—L�.___'_'__Supt. o! Stroels and Sewe�e HY__ �iSE7 CJ �` F"� (/��� <br />_ _. ____' _ _ _ <br />H�-- --�-- — ----- _,�aro��a: 20�3, <br />