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THE CITY OF EVER77T <br />_ Date_ <br />Sketch of Proposed Sewer^ BLot-- <br />Division <br />-CQPPFction for Builyin Situated on mil 3 7./ Block_ ,;•! / <br />or Addition _ — =J<_ `✓_- '�1 <br />o.• fv .� �— <br />!: / Owned by f / `".. ," <br />Application and Connection by_ i' % <br />Remarks: <br />Licensee <br />Depth of S'wer at Connection I I I <br />J I 4e' <br />, <br />i, <br />Connection made the 17 day of. LVk r 19 4//✓. Examined and App roved by/ <br />City Fvntear <br />/ _Sups, of Streets and Sewers By <br />1 no�� <br />B _Inspector - .12426 <br />+e eooee s•a>.a een anq <br />