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THE U TY CIFEVERE T Date_A dG <br />Sketch of Prcposed Sewer Connection for Building Situated on Lol__ - <br />Block---- <br />Division or Additional' s'T T o r L O w L L +' D H U ,%� 1 _ <br />�f %l77. 3&R T-T Owned by / 2 i2(% 5S-= L-- <br />No.— -- <br />4- 7 S T C- A TG C d AI S T G U--___—_-- __--- <br />Application and Connection by <br />Remarks: <br />Depth of Sewer at Connection <br />L. <br />__.Licensee <br />Sq, <br />/ <br />Connection made the. /'J_'"_ _day oi— -- OO ��. _ 19-t . Examined rand Approved by <br />SuptCIry EnylnQlt <br />- - � ---"s <br />_ .__. of St:eots nand Seweers e -: D PAS NE <br />By <br />BY - __r Inspector 2 1 V <br />