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�'I�� CIT� ur � v .Gtc.� s .� <br />Sketch of Proposed Sewer Con�iection for <br />/%�. r� <br />Division or Addition— _ � � � � <br />�r,. _ '� i �, � iJ,r,•t c.,� � <br />Application and Co�nection <br />Remarks: - <br />Depth of Sewer at Connection � <br />/ � <br />ing,Silua�ed on Lot_—L�� °��-� Block_ • <br />> /: <br />�CL-�.-./� i_-- -- - <br />. .i <br />� a_.�t�. �Owued by � , -,1 �i�ti^�E�� <br />/. . <br />jC�- -. f� _�1�_ � J --,_Licensee <br />I <br />I — --- -- -----I I�.. <br />�J_—�_--_.�1 <br />.I � �, <br />�;. <br />/ � �'',�`- ` <br />I� � <br />.ti. <br />- � --��� -r;�-�-- �-;-=>:--;_- I - <br />� 'i ` I <br />� , , —� ,. � <br />Cennectionmadethe.=t—�dayof. __—�l�L'�__19LL� GxaminedandApp:ovedh, >-- �-- - <br />0762.1 ' / . ; �,�, �.�,�;,, <br />' _ _.— Sup�. of Strecis anJ Se��en � H.)� '�� �! �' �`s �. .. <br />_ . J -._ _ _ _-. ..___ <br />. .._ __ . _ .. ... _. .. / <br />r � � <br />Ity ._ � . �':_..: �,_�...�IlisPec�or _ _ . _.__ .." _ __- ."___ . __- <br />