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1'�IE GITY OF' E`'ERETT <br />Skotch of Pruposed Sewer Connect;on for Building Situated on Lot_______�_r �C�_��__________ Block_______ �_�_`t __________--- <br />Division or Addition---------/�111_/Ct./_S_------���C�._---.----- - <br />, J �/_ <br />------------------------------------------------ --- - <br />9" LL-LG __Owned b __, �__ S6rLi.11i.�------------------- ' <br />xo. ------------ -1-�-------� ------ 4�----------/-------- Y -----� <br />��/� � � ' _ Licevsee <br />Application and connection by-------- --�`-'="-�---l--�. n'_( .�C------------------------------------------ <br />emar s ------------- ------------------- <br />------ <br />-------------------------------------------------- <br />Depth of Sewer at Conne�tian I I I I I � I <br />J L <br />, <br />� <br />Connection made tUe_.__�___day ot_____'___ __;------ <br />� <br />� <br />iJl:. _ � <br />� <br />Examined and approved by_______S=�'__ �" ��n. ! t2_.P <br />----- -------- <br />City Engineer <br />-------------3upt. of SLrcets andSewers BY-----"���--- .y- ------... <br />- - // <br />y----------------- : <br />-- ------- <br />--------- - <br />$ �-`-- � �------- -Inspector -- --�----- `�-`-��- �-`- --��-'"Yi'-.- <br />