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"i"'HE `;1TY OF EO/ERE .'T <br />)�✓CR� II <br />Sketch of Proposed Sewer Conn/ection for Suildin S/ituated on Lot��a,�t.1Z______ <br />Di^rision or Addition_/�" r I fi %,�io-./7 �'"hT �✓ /yC� Z. <br />s <br />Ayplication and Connection by rsf'���'���<<' <br />Remm�ks:�--- '� h - !d�7 �- __--- - <br />Doplh ol Sewor ot Connocttoa � <br />`+`- ' c,a-�.a�a..� � � ",�,�,�.u�.-= <br />a,l'' �-ricX.l� /a�..,.t�' Lr.".�' 5=--� <br />�C'ru.: (.1u,,.�a�.C... <br />�h�� � <br />pR: �'J, �o ...._ ��r.: ,:lu:v. �.�,�,e <br />� "F..e�u,at dZti.a._::,_ <br />�r�� ��--{J`�=-�,- <br />�-v`„��i �: �t <br />__-.-- <br />Da�a -?'�/� 3, � rG i <br />Block_ _� ___ <br />�eJ��r �In � <br />hY--- --- - f r i�� s <br />',/ / — ---- ---- --.-_ - — Licensee <br />.�1((L.� 5 F�f�1/OY��� .id 6��JAN ('IRSJ f�� 1�', <br />I � � <br />Y <br />� <br />� <br />Connection made tho. ��__� _day ct____ _��-C� _______19� �. Examined and Approved by_____iG t� ��v�ei <br />�'�C. '_ _ <br />((��..--aa���`�' ��,�,� Ci Engineer <br />'- 'p� � r —'- �— ..—.- --_Supl. ol Stmets and Spewere � By____..__ � F ��rs v� <br />By_'-__' `= f _ _._ . ' _____ ._.. __Inepectur � J��� __. _— <br />