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<br />THE �.ITY OF E\/ER� rT
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<br />Data--�77{-_�`-� .�!%�.
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<br />Skatch of Proposed uewer Connection !or Building Situated on Lol_i,--.=`'-jr --`f-l�— $lock_.. . —_ _
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<br />Aoplica ion an Conneclion by �� �'�-------------- --- --Licensee
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<br />Connection made the. � n-' d�y of_ \`*�-�-�� 19 ��. Examined and Approved by �
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<br />__Supt, ol Slmcle and Sowarn 8y—__.—__rLG-M'��
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