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. v� Y sL ��t' �. .�Lr '�r�v�. <br /> Slce+ch a[ Prop�sed Scwcr Connection for Suilding Situated on Lot_._________ ______ Block______ ._______ __ _____ <br /> -- --- <br /> �ivision or Addition----r ---------- ----------------------------------- - - <br /> J-1_�---------=-------- <br /> -_ -=-- <br /> No. --�- --'—?---�L��r--1----------------------Owned by -----'---------------_-----=-=-_------------ <br /> Application and Cannection Uy-------------- ------------------------------------- Licensee <br /> 1 <br /> -'--=--=`---------- <br /> Remarks --�-�:--1'--=---- , --- -------------------------------- - -- <br /> Depth of Sewer at Connection I I � I - <br /> - li <br /> '/' J �� �� ' ' <br /> � �.���. <br /> J <br /> _ - I- <br /> �l I i I <br /> ComiecLion madetUe_ . ----dny of------ _---------191_.'_ Examined and Approved bV-------------------------------- <br /> ---- --- ---------- <br /> _________________Supt. of utrc2ts and Sewers Qrj�g� City Engincer. <br /> BS'___ ---------------------Inspector. B1--------`-`---------- <br /> /,. �- % . <br /> --------'-----+--- — <br /> _ --� <br />