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THE- rY OF EVERE ." I Date <br />Sketch of Proposed Sewer Connection for Building Situated on Lot �-�' <br />44 <br />Block-_ .� <br />Division or Addition _ (ji,_ / ///// / ,`� / s_- <br />i <br />z Lr <br />No e <br />Owned by- _ 7r_1 •. _ /O_/r/n <br />Application and Connection by //iK��+�. %, C l'__ �� _ <br />Remarks: 1/& Ye _, /PC e'mj A 1 `Sy — ----- -- - --Licensee <br />Depth of Surer at Connection <br />>� jrCuctR xrY.� y_r <br />V <br />Connection made the ` <br />.__day of Examined and Approved by,�!' ,r <br />-- =--—.Supt. W Streets and Sewers g. -1 agineer <br />By <br />G> <br />- - - -- _Inepeotar <br />21IG4- - <br />