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THE CITY OF EVF_RET-1 <br />u_ Date-7 5&_p T Z <br />Sketch of Proposed Sewer Connection for Building Situated on Lot —�Block_ I (tQ W-) <br />Division or Addition— or- W C 5 % co 0 Q D <br />No. C2 '� C� /�i G /1/ o 4 / fJ Owned by—��_ AND 1i <br />Application and Connection by__D_`L f3 TJ A C. k— D It S C/ 5 _ <br />--__ _Licensee <br />Remarks:_ _. / V i j5 /Z M f l` <br />y�r Depth of Sewer at Connection I I 5/{ t I C, li n-I T A C l� <br />cf' i �vt.u.c7�a�-� � b •� <br />f <br />`, <br />v ; <br />00 <br />Connection made the- �_day of — a6 19 �'? Examined and Approved by �l)• <br />01 - Q City Engineer <br />(y LOiIK supt. of Streets and Seware By •� 0 1 f !✓C F <br />204q8• — <br />