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:etch of Proposed Sewer Connection for Building Situated on Lot____ % _______________________ Block ---------- :____________._____ <br />vision or Addition -- `� e --- --=`----- - --- --------- ----------------------------------------------- <br />-----Owned by <br />11 <br />>pli:.itioa and connection by_____ 1_0_ ^ !^ ------------ (,1____________________________________ Licensee <br />marks---__-- <br />epth <br />DrJ1..� of (Sewer at Connection <br />P �11 <br />S <br />nnection made the__)--t! �S c % _ 191.3_ Examined andapproved PPS roved U <br />-� _day of ----- �-- Y---- <br />' �- - -� 071�? <br />Supt. of Streets and Sewers _By___k <br />-- ------..Inspector--------_Z <br />F <br />