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THE G.TY �F EVEI�ET: <br />� ,. <br />� <br />Date �v��, � � � != � <br />Sketch of Propoaed Sewer Connection ior Building Situated on LoL___ ___ 1�- --_— —. Hlock-_ �. _ <br />1 � F, <br />Division or AdditiocL__�d-�� -L �.a� ( y ' �--- ` — <br />1 r. ,' f �•'1 f �. ,� . �...... <br />No.— _J;`j �'�i � ; �+ .�t�-..� � ! n i�' _Owned by--,--% -=�-- �---;— -.L,_�--- <br />AppHcation and Connection by �—ti. �`t-=` t'-1=� !� - <br />. <br />,. ,, �, , : <br />� <br />Rem�ke:— ' --� � ' .� e � . � f , .-/ - _ _ _ <br />Deplh ot S��er at Comsciion I <br />J <br />: y-„ C.m,�:�x��.... � 6" ..�y;cL��..._. <br />: (c$ tiY..�-t ��„�,:t� c��. 5' %, <br />, <br />, .��:_�,tKu- ;a-��ti,�a--cc� • <br />� �'� ':��. �� eC-0..U�C.i�.. <br />: Li` :h.cta.1G.. ({.`lt(1.:....n-� <br />Rcuri�. ;'+_t�.c <br />l( ts,. <br />..-^` ...'" \�.�/� , <br />�� .,i � <br />:\'�/I <br />: �✓ <br />__ __ _ _--Licensee <br />� r ' f r�Y`re �6 _ �✓ �., / 2 r / � � 1. <br />)j'•�,�v � l� j z.�' � � <br />� <br />Connection made the. (_l�i__day oE__ _�ys� --------19-�� ��_. Examined and Approved by___ t� �✓ -f �: i� -�- <br />; -y.. � C(ry Eaginc <br />�1 aa y .i��ll..l 4/ • . ! ,. . .' CI <br />'__ . _ .. ._._ ._ _-_- .Sup1. ol Slrecte and Sewen�.. BY— -¢4='� "� � '-+'�,. <br />i: <br />�_ .20027 . <br />��r��y�� � <br />Hy _. _ _ _ �`.�R=1 �" r � — Inepaclor ' ti� '--- <br />