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TH� G. �fY OF F�%�RE i � , � <br />naca—�/ i� �— <br />Skelch of Proposed Sewer Connection for Buildin,g �Situated on Lot_ __-- ^�____ ___ —_ Block_ ._ k L(� <br />ii�' -� � ; � ' / <br />Division or Additiot�Q�-- � -n��=.J�--�--'n2L-�'�---------------- -- — <br />No._. �' ,G,�n,to•.�j -- -- --Ownedby- — ���_�iLfrrl.� ----- <br />--- <br />_�j� -�y , � • � <br />App'ication and Connection by /11��fL— ��� _ __�.------ __ . _ _ --._ _-- _-.-- Licensee <br />� c�_ • r <br />Rem�ke:—/�-_ 1c_�"�—�-------------_ _ <br />Dept6 0l Sa�ver al Connectlon I I <br />J <br />� X � x 6 �.ti�� �,.;..�e.�.. <br />_�.wY� ./►v.a4..... .2 .t z � )l e�Ct. <br />Q( o� � tL' �t�- �4ua...�..Cc. � <br />r � � <br />��i;. ,� Z.�s� .2-z-co+.�.� .auti% - <br />� <br />�' GZ J�,t C5 P�- ,a_,�..a-�- <br />Ql,�..u.t�. fc f, c-wa �. �4.�,.a_.,�., . <br />:� <br />l— <br />J , I <br />� � <br />l �� � � <br />Connection made the �3��'__day oi ✓7��'"j'�"' ._ 19__. Examined and Approved by_ T_!' _��1�'�kft�-___ _ <br />�/ /�/ Enginec� <br />_ Supt. ol Slreefe and Sewun By—.__. — l-`!' l' `� <br />) 242G8� <br />Hy _ _ __ . /�J � �. _ _ Inepecim — <br />