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S <br />L <br />r <br />THE UTY OF EVERE', C <br />Date <br />Sketch of Proposed Sewer Connection for Building Situated on Lot__ <br />Division or Addition_ ;_ _Q�_ _Block <br />—Owned by -- WV, <br />- -�- <br />Application and Connection <br />Remarks: <br />_ �O <br />Dupth of Sewer at Connection <br />Con <br />b7 <br />