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THE CITY OF EVERETT' <br />Date <br />Sketch of Proposed Sewer Connection for Building Sitn hied on Lot Block <br />Division or Addition <br />No. - -- --- --- — --- -- Owned by 1 - 1 <br />33 LT , 1 <br />Applies ix and Connection by - <br />Remarks: y f "'Imitf -%11i '>f. 0 1/ 1 ,)'7(' t, i�� <br />Depth of Sewer at Connection <br />r <br />I <br />Connection made the— _ _ -day of <br />i <br />Licenser. <br />---192_. Examined and Approved by-- <br />_ Cltr Eot{Inar <br />Supt. of Streets and Sewers. By <br />i <br />Inspector. <br />i <br />