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. THE C.TY OF EVEREi : 7/- � ` <br />Date��/' � <br />; � <br />Skelch of Propoaed Sewe: Connection for Building Situated on LoL__ __"'' �1 ____ ___ __ Block—__.1.— __ <br />.. , .;�p � , <br />Divisi�a or Addition__ .;�_�_��•, . ) � T �� ---- <br />�,� .. n:, �•I J� , :1 E <br />No.. __ —G ✓ / : .-[ --Owned by_ —%-� i- � •��_.� —:••� , — -- — <br />- , � . , 1 r �j-- --- <br />Applicalion and Connecflon by � « — : � '� ___ _ —7 /7 ___ _ _l,icensee / <br />Rem�ke: / . , � -- `.,. �:' � � � "'' — - --- — -------`a'lf �°�—V �,�.r. �ic •� �h 4�! <br />DePW ot S�aer al Comectlop <br /><� I� (I.C'YI.Y�..L.l_l/.-�t U L i� <br />Lif I,Oi,�' ��c�u�.C� ,�''uiF. j <br />LU..�.%a.�y� , <br />0 <br />ll." ��.y".�. l_.D�.�fl�t-� ,4.C�:: <br />`,G 'M-.��id.l-�. ll.'t.at.a.w • <br />L� <br />� � <br />� <br />Connection made the_ _� C�_day of_ ___ . 1����� `/._ _ <br />� . �✓ ,� t <br />� <br />- �i , � . <br />___19 � '�. Examined and App=oved b �� ' % " ___ <br />Y-: <br />�, � % ,.L.. Clry Eag(neer <br />_.__, _.�^-�c.�_..c-.. __-4..__.—. _. _. _ Supl. ol Slreele and Sewen Hy.__ �`•:r— �'. ". . <br />_ � �_ <br />By___ _ . �—�-�\�� l�-<f ,- __.—_._.._ _ .Inepaclor GO�C� <br />