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THE CITY OF EVERETT j+t, s- <br />Date <br />Sketch of Proposed Sewer Connection r r rt,atai„d Sit ntnd a„ Lnt —__ Block__ -T <br />t <br />Division or Addition L <br />No.._ r1_ rY1 <br />Application and Connection by <br />Remarks : <br />Depth of Sewer at Connection <br />so <br />00862 <br />Connection made the_ <br />By —. <br />Owned by 64 <br />Licensee <br />I <br />%liLLLc'7 '< �r <br />I <br />_day of �192i1 Eaamined and Approved by ✓i <br />itr Engineer <br />_-__ _ SupL of Streets and Sewers. DY . F'd <br />Inspector. <br />