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THE I.ITY OF EVERE'. T Date <br />Sketch of Propose(: Sewer Connection r yjldin g Situated on Lot—_1I — Blocky <br />Division or Addition._— �p� _ <br />No._.._ _ L[l Wr,44 �Owned by 2nl -Er 4 <br />Application and Connection by1 Licensee <br />/fJ 0 PPOA,,; :d /2079 <br />Depth of Sewer at Connection I <br />6. r <br />OS WLct <br />Q k4% Ct�tr�n� fZ cue 4,.I f <br />i <br />Lin <br />Connection made the. , `4 day of _ _ 19 C �r. Examined and Approv d by / ! ✓ <br />City <br />Eaglneer <br />�l �(,�(�F{,�''� __—erupt. of Streets and Sewers T{y-.. <br />By _ __ V-4�• 4 __ —_ --Inspector 22043 r <br />