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THE <br />CITY <br />OF <br />EVERETT <br />Sk h f ID d S C f r <br />Buildin Situated on <br />Lot <br />Block_ <br />etc o roposc ewer , onnechon o g — <br />Division or Addition_»` --- — J. <br />`f _�tJi1 Owned 65'—��,- <br />Al <br />y' s r-c : — _Licensee <br />Application and connection by -- <br />Remarks -- — - — — --- - <br />Depth of Sewer at Connection <br />Connection made the --'—'-day of _ 190 Examined and approved by ----- — <br />J.___ 01732 <br />�jy t_ - ��--Supt. of Sheets and Sewers. By— <br />f .� , ; . —Inspector. --- - <br />i�y_ -- <br />City Engineer <br />