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T�l E �17 � <br />�F' E'�/E�E 1 � `�_._ .--., <br />S}:etch oi Proposed Sewcr Conneclion lor Building Siluated on Lot �_'_ .___-__-- --- — <br />/ '-�Division or Addition_ ��/!O/i� -il��. , --_�..- �,—�— <br />�� � .�:..; • . -,��.: . <br />� : <br />No.-- —(h-�fj_�.}7��---�: �_� _ �•-'--- —Ownedby.__ --- ---- <br />�_. .; r. . . , ,� Z�� . . <br />Applicatian ar.d Conneclion by____. _- M'' `.---- ----'-- <br />Rem��a:_._.----`— _ ' -- — -------- -- <br />' l <br />Doplh of Sevior al Connecllou <br />Block_ - _ <br />� �� <br />/ <br />�I3��� <br />!l��- - �--_ <br />T �` <br />��$Pzv='+�.`.. <br />� <br />f� ��' '' '`` � <br />s �4 _ <br />� � <br />��, � � 2_I <br />:1�.� S —i._._ , <br />I G ��, <br />-- � �� <br />I � <br />� � � <br />,.; ., , , <br />Conneclion mada iho_._____day oE-____._---.— 19—. Examined and Approved by_. I' cii� c�<;;nc« <br />,,. <br />- ____"'—Scpt. o! Sltteln vnd Sewen DY------ <br />DY --- - �------- —.In�pocm� 1 J � J Q <br />�;. ,.. ,,,.. ,� <br />