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i,>> r`-G� THE �.IT'Y OF' EVERE- T ,�, � <br />�� ,.�i;�,��i� <br />Date � <br />Sketch of Yroposed Sewer Connection [or Buildinq Situated on Lot__ __. __ j'i. __ _ B�o��_ fy �� _. r- _= <br />Diviraoa or Addition___•�,_`_ �'i" --_�-_ri �; _ _ .�/� . �' <br />' i - <br />-..,. -Nci.= -' - " : . i <br />, — i , .4 �r �� _ Owned by-- �=. ,'" v ::r_�t�a — �-�� �� <br />Application cnd Connecdon by _ ��.-' �J.'-+ I"-.- .t i"' f � <br />�� '�___��� <br />r : � � --- ------- _ Licensee <br />Rem�ke:--- '' J'y �' <br />�--- -- -- --- <br />DepW of Sa�or at ConnecNon I <br />I�� ..�,f` <br />6 :.' <br />✓ � <br />Connection made the__1/ __day oi__ i��_'_�_'_' <br />I , �.� � � / J � <br />j- ,.. ,�,« j / C� � <br />� <br />� <br />%6 <br />,� <br />I I � <br />----18 �—' . Examined and Appr9 ed by_ ��� ` '/. L� � _ <br />""Clt E ' <br />y ngmcer <br />( ,j --__Supt. ol Slrocte and Sewen BY---<_����-_= �'i �'f3'�(�a-a.� <br />B _ Al�i'=�. �- <br />Y — � �i. �'�'` —_Inepectov O i � <br />�:,� ...�....��.�� IS21 �. _ <br />