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u <br />T��E GI'��' O1� l��'EI�ETT <br />ls;cetch of Proposed Sewer Connect;on fo; Building Situated on Lot___________________..__________ Block___L__________________ ___._ <br />Dicisioner Addition------------ --------------------'-.:.------------I---------- ---------------------------� <br />Np� '----`=—`-----`-------==----------------------------..Owned k9 ------------= ---------------- --�`_ ��,.---=---- - <br />A lication and connection by-''=-----1-- ---_t,1.'-----�--;�._-----_,,------ - <br />R.emazks ------------------------------------------- --- �, <br />------------------------------------ Licensee <br />-- ------------ --------------------- - - — <br />Depth of Sewer at Conne�tion � I � I _— I I <br />' �.. <br />, ti �-�- ` <br />f <br />� <br />4 �. — <br />«1` �. <br />c�!¢ <br />I <br />I I <br />I � I <br />� � � ��� � � <br />Connectiar. r,nde the�i%__day ot____��_____ 1�J1 �.` Examinedandapprovedb•�______________ <br />------- -- -- ----- <br />. _�J-�/_`� � c ��103 . ..:-. . cet <br />Cit�• Ene n <br />- - � - <br />-Supt, of Streets nnd ,.ewers By. �. ____ .-__. ______. ______.__.. <br />f r /'� <br />B�. _.---U� �L�P�ra -f'�(_: - --- Inspector __ � :.__ �.. . ..:. � . - - _ - <br />� <br />i <br />� <br />