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a <br /> _ o��.: .:A � Y o�c� � Y ��. . - <br /> Ske�G� of Proposed Sewer Connecti��n for I3uildin� Si�uated ua Lot i 1 :._� L'lock l � <br /> . . J' . .. ._. . .._ _. <br /> Division or Addition-___�_ ' <br /> - ._ - ---- - - — - <br /> ,, �p- ----�- --Owned by_ _ ' _ j � - - - <br /> No.._.-- + , <br /> ---- �-�� <br /> Apf��'cation and Connection by-__ ___ _____,_ _.___ _ _ Licensee <br /> Rcmarks:—__ __ _ <br /> --- ----__- ----- --- - ---- <br /> DeptL of Sewer at Connection � I I <br /> �_. <br /> _ __ - - - - - --- - I <br /> _-. ___ -- -- - - - --- ' - - -I-- <br /> � � <br /> : � <br /> _�_ -- . <br /> ;�, <br /> � <br /> -� -- _ _ _ ---- - -- ---- <br /> -- -- <br /> I � I--- <br /> _� <br /> , �� <br /> I ---- -- -' il <br /> I — -- -- ------ --- --- <br /> I <br /> � I I <br /> Connection made the_ _'y- _daycf__._. _ _ 1J1 _,� Exa�iu,e� p;i�Approvcd by -- <br /> J ZS Ci��� faiginecr. <br /> _ . _ . _... . . _ _ . SupL of Strcetsand Sc��crs I3y. .__ _ ... _ ._ — ------ _-----. . <br /> � _ <br /> IS}� _ _ _. _ _ . . .___ ._— ._ _ Inspeclor <br />