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THE CITY OF EVERE) T' / <br />Date <br />Sketch of Proposed Sewer Connection for Building Situated on Lot _ Block__--_ =. <br />Division or Additiotl V—zr— L <br />Owned by - <br />Application and Connection by___%l �j r _ <br />---- - _Licensee <br />u <br />Remarks:— GoNNIL/z 4612110 -- - --- --- <br />Depth of Sewer ut Conneceon I <br />l t; <br />3'� <br />4" fJ, Cc��tx�$a Rcwcr. <br />(Owl' -) <br />Owl' r) <br />Connection made the- !.i_=_day of — e __19 b . Examined and Approved by 1Vj C A4V�� <br />Eaglneer <br />-----._----supt. of Streets and Sewers Hy_�,Lc <br />i <br />By- --__ - Inspector 22220 <br />