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._.- <br />,_�, _` -----�--------- s�o�k----=-'--------------- ---- <br />, - • .;, <br />skecct� o! Proposed Scwcr Couner.6:an for Bttilding Situlted on Lot__ -L--------y _ 1 1 f` , <br />.i-,. ,.=---- � 1. . : , <br />Divis�on or Addi6ion----=- - - '-=---`---------�'--------._-------- � -----=-''_--"------'--�----------------------- <br />. . � � . � .( _ � � �l � , � . � ,..��i <br />� ---Ownedb -= -------------`--- - <br />No. --------_--- . ------- y -r-----=-------=-----=�----- <br />------------- -- <br />Alication and connectio+� b ' -" --------------------- Licensee <br />PPY--------------- �_-------`---------------------- <br />Remarks ------- --- <br />-------------- ------------------- --- - ---------- <br />------------ ------------ � <br />Depth of Sewcr at Connc:tion I � i I I � <br />_ - � j i <br />, � � . ; , . - , . <br />_... . ; ; — <br />, � i �r��.,�� �� � � ", � � <br />:��,1 <br />� ,, <br />Connection made the_c_C <br />_�_� _!�.l _� <br />-- B�--- -�'�Q�-�u <br />/I � I . I-- ' 1 <br />a�______� 'i_�[____ 1�J1_i.� Examinedandap rovedby________ -'-- ----- <br />---- - - <br />(� �-70 3 CityEngineer <br />e�---------Snpt. of StreetsnndSewers BY----_-------------------- — _.__... <br />/. _. _ <br />__ ie.k--- Inspector -- '---------------- --------- --- <br />