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TFiIE CI`�'ti' OF �VE�!ETT % <br />�/ , �_, -� � ,y6 .. <br />U�� �/.T/' � .n � f � ��5 Date_ --�--- <br />�/A�.� .l � /�.:.: a/s N.�r�' <br />Sketcn oE Proposed Sewe7 Connection for IIuildincj Situated on Lot_ __ __ _ . Block, A'�__ <br />/,S: .liii� .`LgJ' /S of N[rG°ar �%.E.:'3 �t: �iT?e.:?si yy�c/T� <o H. -- <br />9� > 9 1� f-„• ;:.-.Ran <br />Division or Addition __../hr �_�� _ �2'_��'��. �t� � <br />— -- - ---- -- --- -.. .. - —. . <br />• �� -- <br />. ' ra -��i1 er <br />No._ �'_''� / aI �- -- -�`'^'� -i�, _Owned by. . � - � -- - - � i C-- <br />�� � � <br />9pplicahon and Connection by __ � __ __ _ _ _ _ __ _ � _ I � <br />/� � � �, / �/ " Licensee <br />.y��nr. .. 6 1..� f//I�9�F r�� i%�.i.n.. (� <OwPI' �/� �1�.-�f���OriJ _ <br />Remarka:_ _1' y� -�.22 / v _ — L — ¢' - / ' <br />-L: G'�� - .Y'r.a�:i. rT/�i 'i!'�i-.J�tusi-)��.,vLrit�%i75-- _____—. _ <br />� � ✓ • , r � <br />DaptL o� Samor al Cannncllon <br />.� /.Z `t ��� <br />�J s � o4-S <br />�I- lyj-7y <br />- --,y-���s- .f�� <br />-----l��r�-��� -- <br />Connection made Ihe dav ot 19 _. Examined and Apprcved by. �Y��'• �n ��''' _ <br />'/' City Enginecr <br />._ Supl. ol Sl�eola ond Sewou 5y `�_�('�� v�� _ ______ <br />..� <br />