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THE CITY OF EVER.FTT <br />Date , <br />Sketch of Proposed Sewer Connection for Building Situated on Lot 1 — Block <br />Division or Addition__—Z1""—� <br />No, = 3 a+ <-f�C, r f4YP //__ Owned by C, IF 0t 14VIJt=, <br />Application and Connection by E L1L<<<% % Licensee <br />Depth of Sewer at Connection I <br />I � I <br />Connection made theday of / y CG "r`o t- 19/ o <br />Supt. of Streets and Sewers <br />By • ' Inspector. <br />u Loess s•n xsx aw <br />Examined and Approved by 6/& /al <br />car �sr� <br />By — <br />1182i <br />