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'�!'(-iE �I"I'Y OF EV��ETT <br />-- -- ------ -- <br />S/telc/t of Proposed Semer Conneclion f,u Beilding : i(ualed on i,o! __:�-f- _. _ Bloc/z_ <br />Divrsion or Addi7ion <br />— --- — ----- <br />tVo. __ - — �' —� _ Owned 6y _ --- <br />,f�PPlication and Connec(ron by — � _-�Lr� "'_-'� . _, ' ,-) _ Licensee <br />/� emar/�s _ ! <br />Deplh oJ$eme� a! Connectiort I I � � <br />� ;i <br />� _, -:,ul�`.: � � <br />•_—_— � ,. . . . ' t . 4-._ .- . ! <br />- --- . _. . _ _._ .. . . <br />-- -----'--- — —�-- <br />-- -_ ..-- - �-- <br />I_ - -- -- � . . --- . I <br />� I I <br />�necl�n made he_ ��o� _ �-_ --_ _J9/% 6xnmined and Approucd by ' l '-" . _ _�_i <br />� ��`y G�'" S�pt. of Stree(s � Semers. <br />/� <br />�� -, ��.,� �> / <br />(/�j'� •'.' � G4 = /nspeclor <br />U49�3 C�[y �ngincer <br />.3u ' . <br />