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. . .__ . . _„_ <br /> TI-IE �..TY ��F �'�i'ERE`f ; <br /> Date a'i�4�.�`� �--j-f <br /> Sketch of Proposed Sewer Conneclion !or Buildinq Situafed on Lot_ . .- 1 -_ _� u __ Block_ '' i' <br /> _ <br /> Division or Additio� r����� % ''_r f� �� , <br /> • —�— -- — — <br /> i C n � l�r. �.t .,. � J� _Owned b '�'� l'- I`' v <br /> � No.—�-- -'�- ----- � — Y- -- - �-�L�s�L`�..�--- — <br /> A licafion and Conr.ection b L'1 ��i �� '� 'i� , , ' <br /> PP Y 1�--�--rj--1'f— '-- --- ——-- —l.icensee <br /> � . <br /> Remarks:— t� �``��--{� �� _ _ _- __ ...— <br /> `���------- —�--- <br /> Depf�,i cl Sowec al Conneation I 1 . . . -�—� —��—� I � <br /> I � <br /> _'_ --_ � � .. �; 1 � ' �/ �� � _ <br /> �� � <br /> i � <br /> 1 <br /> '. 'l. � �, ;i <br /> .. �� �J� i ' ' <br /> �{ r� '� � h4 �� � i � ` ` <br /> / , , - � ,I , ��Y - <br /> �'• 1�• � •4' II . <br /> . I �"' ��I.S � <br /> , <br /> � + <br /> • � �IU�� ; �4� <br /> - � -_ � �: �� �,� I <br /> I � � <br /> � � � <br /> Connection made the..�1�__ _day of -, , _—'_/;�___ ____19_a: Examined cmd Approved by_ ___ •'�%:j' �__ I <br /> V ;•^Ctty Engineer <br /> . —�— -- ----� ---- �----- ----�upt. ol Slreole and Sowere By__ . _ . _._, _ . :.;-�i.�. %,a... <br /> � . ' . � . . ,- .' . <br /> ,. /� /l�y , <br /> Bp'�__'_ '___"_______.� ' ' _ — _ ._ Inspeclo[ �'i V / � ` <br /> � li�R���I[III[�Y��CY�tC. �11)1� � � <br /> I <br /> I <br /> .. � �"\ <br />