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THE C.1Y'Y OF EVERE"► T' <br />L- <br />Date-_-z_G _.�U���Q <br />Skelch of Proposed Sewer Connection lor Bui:dinq SiWated on LoL. ✓ N_� �_ __. ._ Block. __ v.n' �C..____ __ <br />Division or Addilion_ ..� 4: �%_/�_r r A C.�+ C'� <br />-- ------------ <br />- - <br />- --- �---- ------- - <br />A�! �i. <br />r�o.—r,,— v_– T i-1 5 T —oWnea b C' � n w/� ��. �� �v E2 <br />-- -- Y — -- — -_ - - - - - <br />Application and Connection by__ ��yW_.1��-j /G_�_ /�L U.L! /3 c'/Z __ ._ Licensee <br />�, �� � O -,;�_'r- _fi _( Z S Z_3 <br />Aem�ke: � - ' �'—� =2 - _ <br />Depth ol So�ior at Connecllon � I I � <br />�'��� C.C'�t,t�. � b„ „�/�LN <br />lY` l3t.Q.� �iLil.a�..Cµy �llti.i <br />V � <br />'f /,, / <br />t�;.e_e,� . <br />y " i��}'1, C,r�+.u�.c.t<. �a.c �c4 <br />�'�.k �, �O (i.e,..u� c(n,s.�;K, . <br />V- <br />i <br />� `Lau,x. ��� .�vwd� <br />c„�, ,c..�,� _ �„� � <br />-,.�-_� � <br />1t i..a.. _ �—_ _-- _ —_—_ —'_ I— <br />1 f �l I- <br />Connection made the ��'�day of_ _ �'-�°��- _ 19`�' `�. Sz¢mined and Approved by_ �._V _=vC_)�•�-i I�/ <br />.�_�.,/� ��% c��y c�,q��,.�� <br />— - - - '��-/j�M�/�( \� -. .. _ . _ Sup1. ol Streets and Sewere �y. .� 2 �_Q _4� /'�_. 7 /V �.s�__ <br />__ / \_'i. / . . . �Q <br />HY. % ' "� ' Incpcclot ��v��. , � <br />