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THE ;ITY OF EVER�. �T t�,. ;,:r,,;,�h <br />�e- <br />Skotch of Pzopoaed Sewer Connec6on tor Building Situated on LoLN ��'' J�Of L- Block— Z3 <br />� � �,; <br />Divisioa or Additio�_- y ' ` ' _, '��l%1 : /ar�.=/ ---- <br />No._T.l %v i; i! : 7� i-' � Owned b `�o t% �� f' �' c.�iU.•'r i/i <br />/ � Y—=�=— — — <br />Applicatloa and ConnecHon by_ J•// �r•rt , ;, - .'✓r•: / �. C� , --- —l.icensee <br />` / � , <br />Rem�ks:______Y C��� [/�ilr.� �C a%. �. �� f � '�: f — - --- - <br />DepW ot S��ve� �:: Cowectlon <br />� I � I � <br />�--� . I ., CT.�'ir�/r'% �l�f � /'Yl�. <br />l..du-�ei,�.,_. t -� <br />�,�. q3 � �.�. � <br />rn��e.� , <br />� .. <br />. <br />� <br />a�.°�`�-�'� <br />�10 • � <br />�'' C S P t. . � • . �; <br />�—'„:�;-..� <br />� � <br />/t4 f�,��,���� / �;,�, _ � , r <br />Connection made the—�b day of ���--" '--'""`( 19 ��Examined and Approved by_�: ; _- ''' J <br />� ' .• _ 2".�. Ciry Eng(ncet <br />�'�� = ;�'�; _, <br />--. -__Supl. ol Street� and Sawen HY__—_ _ __ % ' • <br />Br — �- —_m.r.��o� 16984 - <br />�� ..,, ....<�, �o <br />