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��-�[� ���' � �`'a ��lE�.��""`T <br />3kr.tch of proposed Sewer Connection f �r,. Building Situated on Lot_ __ %" -_ ._ _-- --- Block��— — <br />Division or-Addition— � — --- <br />� � <br />N�.—_ - .., � � ..�Own�d by_ .� r � -. " .—'%" r'" .7 � �-- -- <br />- -`-- . -- . � --� �.� ^ k,. . _�.:�- �_ i - - - - -- Licensec <br />Application and conuectiun by_._�� ---- <br />Remarks__-- _— -------- - --- - <br />Depth of Sewer at Conn�ction � � , — I � <br />--�, <br />,, <br />-- -- --- - --- - <br />, --; <br />/ `� - <br />: ( /`�,_� -: ;; , i _ <br />- ----- -y--- --- ---- � <br />.' <br />;�: - <br />I: <br />,; <br />,�;�;.,� <br />/.�_ -.;%`" — .<2-r'" ---� —_ i - <br />i , ... . ._r:' <br />� 1 �-�� - I � <br />/ <br />Connection made the_ , � � �day of . _ 190 i� Exumined and approved by <! � ' � '� � � ' ' � <br />i ,___ ,- i City Engineer <br />�� - — --S�ipt. oE Streets and Sewers. o���� By '�: � -'�`-'''._.. . c , <br />- - A � ,. ' , �,, <br />; - <br />B'' ----- ---- _- _—Inspector. -- .-r - -=' <br />}, -- <br />� <br />