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•1 / THE CITY OF EVERETT <br />SkeL1 1• ""�� Date <br />of Proposed Sewer Connection for Builditq Situated on Lot__- arm <br />Division or <br />Application at-' Connection by_K/O/V <br />Depth of Sever a: Comection —. I <br />Sso y»/4 aXx <br />Gcs.G' z <br />f <br />"r <br />:y <br />'�-- ---Rec.—� LCLsL.s.d_ <br />Connection <br />exe-V <br />Connection Fee $ 1 "6 <br />SEA srsETc� <br />L <br />M <br />' I 32231 <br />rz- <br />Connection made the- Z, /�/�a / <br />_day oL__ y�TExamined am by �IAGLvAl� _ <br />N City Ergfneer <br />---------------_. —_Sups. of Streets and Sewers Hy <br />✓ -- — _. inepeclor <br />