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THR CITY OF EVER77TT <br />Date <br />Sketch of Proposed Sewer Connection for Building Situated on Lot Z41 - /y r/ S . .Block <br />Division or Addition_ <br />— <br />No.—_��r / ✓ % �� / Owned by <br />Application and Connection by �� �/' J (I ' J Licensee <br />Remarks: <br />Depth of Sewer at Connection I I I <br />i <br />7 <br />� Connection made the a ay of. 19 <br />_ Supt. of Streets and Sewers <br />__ -� d <br />By L- - -- .S+_—Inspector <br />IZ Yo�>n� C t>r •N ellat <br />Examined and Approved by <br />i Qo, Enafsm <br />.- <br />12354 <br />