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T�� (;I'�� O�' EV'�,RET'T <br /> 5ketch of Proposed Sewer Connection (or Buiiding Siwated on L.ot_ _____ __ __� ...___._—_ Block_�� _ <br /> Divis�an or Addition__� . __ _ _ ____ _ <br /> No.—.' ��_ � Owned by —=—.11:..-- _— — — — - - --- — <br /> Application and connection by `" � �icensee <br /> Rcmarks__— ___ __ _—___ <br /> Depth of Sewcr at Connection � I � � <br /> ----- -- ---- ------- -� - <br /> � <br /> � � � <br /> I I � <br /> 1 <br /> i <br /> ` i � <br /> �;;;I I —=-�-- I <br /> —, _ � . — — — -- ------- -- —I— �. <br /> � <br /> I � <br /> —I --- --- ------ - -- --i - <br /> -I I I I <br /> Connectian made the�__day o[ __.190 Examined and approved by_ ___ <br /> Q r�rJ 8�' Cilv EngineeY <br /> —___________Supt. o( Streets and Sewers. By_ � <br /> ,, <br /> BY—-- -- Inspector. ---- -- — — — <br /> ., <br />