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, � ! �IF CI��'l� (�T�� �r1TE��L1"� <br />Ske!cS� uf Propused Sec�er Gcoanect;�n for Building Situated on Lot_____---� :__- ______ Bleck______ r� �__----- --------- <br />D;v;�err-�r .Grlclition---...--�1�1C �1�Ltt-----._�.�-�L----- - --------- <br />---...------------------------------------------�--- <br />.,; �.-_, - . <br />�.—.�._ I" ,� ,�� c_______________________ " <br />1Sfo. _.�_ . = :: =-' -- - ------_ 1C J.... _--- --------------OwneR by ----- �-'-�I -=--- `_ <br />•:.;'-;� /�; � ' q/ /� - !• --- Licensee <br />A�licationan�:.:,�nnection`� � -I!_L:•_-_/--CQ%_[`.-------------------------------------------- <br />1N Y-- -----------:1-� <br />F,mares _..-------------------------------------- ---- <br />--- --- -------- <br />--- _ -- — <br />Deoth of Sewcr nt Cunnection � I� I i I I � <br />L___ � <br />_ h�,��C_ <br />� � �� <br />4= F �- [ <br />�'`e �o�,n� f <br />I�� knf�p�` <br />�' I���! <br />� <br />Connection made tUe__�-_�__day of___!,_�__'_---.=— <br />, <br />� C�.i_>;, /I �- _. <br />� I.�'� , � � . ._ � <br />��� �� � � <br />1J�1_....� ' nnd approved by---- ��__�!�'/l G----- ------ <br />��r, / s-���� Oity Enoineer <br />[/ <br />__________Snpt. of Streets and Sewers By__-- -' --'- ��-- ---r------ --- - <br />� � ----- Inspector ------. __. . _--- ----------� --. _ <br />$Y -- - ---- - <br />------------ -- <br />