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THE CITY OF EVERE`1"T !_ <br />Date - - d ' <br />Sketch of Proposed Sewer Connection for Building Situated on Lot_6zH <br />Division or Addition ____ _— --Block <br />No_ Owned by - <br />Application and Connection by = % • 7 , - <br />on <br />Remarks:_ �p "` Rec. #_j <br />Depth of Sewer at Connection <br />j <br />Connection made the. <br />7 <br />.day of <br />314G'7 <br />.19__ _. Examined and Approved by t�L JIJNd <br />city Engineer <br />Supt. of Streets and Sewers By_ <br />Inspector <br />