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I <br />" THE Cil ( OF EVERE:TT" Date t— - <br />Sketch of Proposed Sewer Connection for uilding Situated on Lot_—_ / w'�` Block — <br />Division or Addition_ ! �1y"/ �) 1 <br />AppBcation and Connection: <br />'--- " - <br />DepIL of Sower at Connection <br />r <br />Connection ads the_ �t V re{��..i.r <br />—_—day aL—��I9�. Examined and Approv by <br />City Eaglnee <br />_-_—_Sups. of SUoole and Sewers Hy— <br />„y 2 0 3 55 . <br />— -- -- ---- ---licensee <br />