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THE CITY OF EVER�TTDote_�-�,-�_-- -- <br /></ <br />Sketdi of Proposed Sewer Connection [or Building Situoted on Lot---_� C— _— Block— _�f- �— <br />Division or Addition t- ' � --_ ____ _. ____ <br />- � ��' --7 <br />N��.—���� ___ ' ' ' � !`�,q �� �y-:.� •�.,:, ..',+.�1 <br />� — � —Owned by-- � <br />Applicntion nnd Connectimt by— � �' •�! . = �' -- ' -. _---�- � -- <br />Remnrks: _ _ _ <br />Depth of Seaer at Connectian <br />_ — Licensee <br />I I I I <br />� <br />— ,.1 'l : , <br />II-- — ----i - <br />� <br />—�—� ' � <br />—'. —_ __— —'__—_ --_ — � _ <br />� — � <br />III�iJ � <br />Connection mude the_� 7 dny of_./���/��vl _. ___ _19��[. Ezamined und Approved Uy _�. �� • y' '' -- <br />`= citr E <br />npineer <br />___ ___ Supt, oI Streetc and Seu•era 8y_ <br />By _— _ _ _Inspector ��—'. .. .. _ . ___--_ <br />