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Y li yam. CY L JL OIL" L` r %,.i <br />Sketch of Proposed Sewer Connection for Building Situated on Lot__ _ ___ Block_____ _ ___________________ <br />/ J <br />J--- �� .---z• 1 �--------------------------- <br />i., <br />----------------- <br />Division or Addition ----------------- �_____ <br />No. ------�= `=-'j�'�E------- )Q�----------owaed by--t*---- --`-==—'-�---==:4-_6!_ -_r z.,[-'---------- - <br />0--------------------------------------------- Licensee <br />Application and connection by___s <br />Remarks- -- --- ---------------------------r-------------- ------ - - - ----- -- -- ----- ----- --- -- - — - - <br />Depth of Sewer at Connection <br />I �I <br />2.'•5,.y k- <br />Connec`tion made the__4 __day of___ ____ 191_L Examined and approved by: <br />__1 /__ ��ES�/ _ I Supt. of Streets and Sewers �s � <br />ByIS ----------- Inspector <br />