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; <br />_ --�t � ;, � �'THf CITY C�F �VEF� �TT j�r ,� �� <br />, Date <br />Skelch of Proposed Sewer Connection tor Building Situated on Lot _� __ _____ B]ock-____. �- � ____ <br />.1.. . <br />Division or Additigp-- -= i '.L✓_t 'i % ' <br />/ — - --- <br />LE� i / f G � r; ✓ �" a' � �/ r/./��': � (�Ur �� . <br />No.— �L� — --� f ---- --Owned by _ _-" ' -=------�-- - - <br />_ , / - -- - <br />� � <br />AppGcation and Conaection by ��� •��_=+_J-- -j _ �0_� �-_-__----_ -- -_- . _ _ Licensee <br />Remarke:- - ---v- ��. `�_�_C:=� -- -- - - � �'� � �� 1'" "' �t ^ � <br />�L: _L-- 5:-�1�"7 <br />Dopth of Saoror al Connocllon I �. . I <br />�.l <br />�� ,}�. (`.-� W' ��ti/i lLl� <br />L�lA.ylt_� <br />.��C �"`��.tr.f.t.i�y � : <br />�, I <br />l-'. ., , . <br />� <br />1 <br />I I <br />—� — ---I <br />� � ( � <br />_ � <br />Connection made the_1 �__day oL__.�: !`����,ia' ___1�7�. Bxamined and Approved by____;%_��`� �C�t- _ <br />' }� _ - _ _..� � / .. City Enginecr <br />��—�_�'e�a�' _..— .Supl. ol Streele and Sewen By ___�r_rc'�—L�.l+��"'`� •._,_ <br />__. . �l�=l/'2'rt�:._______. .__- . <br />By—__ ' — '_r __.___._Inepoctoc ��.Up�/ '___ .__ _ <br />.j:�.: .,,� ..�..,, « G <br />