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'f��E CITY O�' EV]�RIE'I"9�' <br /> Skctch of Pro�;osed Sewcr Connect4on for I3uilding Situated on Lot____ ____.____ - __._ Block__--_ __ <br /> - .. <br /> Division or Ad�'ition---�:.- - --__--- - -- -- <br /> No.-- — --�-- ' '=___ —_—Owned by--` —.�_�'-.__� <br /> Application a..� connection by _ — _ Licensee <br /> Remarks — — —_—_— — <br /> Depth of Sewer at Conneciion � � - � � <br /> ___ __ _ . -- <br /> P --- - ---- ----- ---" -- --' — <br />� � <br />� -1 <br /> � � . <br /> � � <br /> � , _ <br /> - ______ _ __,._ <br /> _ _ _ ,: �_ __�_ _ _ - <br /> , _ <br />� <br />� <br />� � ___ _ _ _ �_ _ _ _ _ _ _ ___ _ _ � <br /> , ___ , <br /> � i� � i <br /> �onnection made the day o(_ ____190. cxamined and upproted by_� .. ___ <br /> City Engiuecr <br /> ___ _ _ — �____ —Supt. of Strer.ts and S_��ers. �26�7 BY. <br /> --- — <br /> 13y _%_ __�_�__ Inspector. . <br /> � <br />