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1� <br />81 <br />' D Et''ERE' T <br />v ThIE CITY OF Date T -„e- <br />,S�y�y <br />Sketch oaf Proposed Sewer Connection or Building Situated on Lot—._— —.- - _. Block -- <br />Division or Addition % n A &ewe- <br />Owned by_ la .�- �!•—//" Se.� - <br />Application and Connection <br />by <br />7e-�� B---------Licensee <br />Remarks:-__�`1_- <br />Depth of Sower at Connection <br />11-" �, tt <br />rt:E e".k- { Ytanr 1 • <br />�- <br />a a µ z \ <br />✓ I <br />Connection made the__.`=— _day of__ 19b`l. Examined and Approved-by,_4f_ <br />- _- _-___ --_Sept. of streets and <br />soaors By__ <br />By _-_—_--Inspector �2b9 /�y .--� <br />