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TI--IE �,;ITY OF' EVER� rT <br />;i <br />Da�a_t� �: � � � <br />Skelch of Proposed Sewer Connection for Building Si!uated on LoL`_'_�' �' __ �_^_.�� ___ �__. '� Hlock-___._ <br />Division ox l�ddition—.___' '_ ': - . - _ ' __ __ __ <br />Nu.__�. �� _Liy�1+�„- ---- Ownedb �i���- ' �'�--V,,.. -- <br />y_ _.l�.cr ���., �•.,., ' - --- <br />Application and Connection by r%�!�� p�- _________._ ' i_ _Licensee <br />_ --- - -- <br />T � _____. .__ <br />Rem�ka:�� o �� "7, _ i i- � � :'1I = --� �" -_�-,-- A'� ^ � --- <br />Dopt6 oi Sewor at Connedfon I ( . � � <br />��J <br />I � <br />J� ,�„�- � <br />� � <br />�,7 � c�..�,� �.�.. c �, <br />Connection made the. !�_ _day of- -__ ___ ______ _ 19-_. Examined anri Approved by__ t �v� �- � ��: r 6� _ <br />� — �� j — ' City Engineci <br />------ �� .-- . _ Supf. ol Slreels and Sewern Hy_'i.(.�'__.�_;',✓I i�� <br />Hy_ _ ___ _ _ _ _ . . __.. �. Innpocto� G5002 _-- —_ <br />