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THE CITY OF EVERETT <br />Sketch of Proposed Sewer Connection for Building Sitaated on Lot____________ <br />Block--------- ----- - ------ <br />------------ ---- - <br />Division or Addition--------------------------------------------------------- <br />-`---------------------- <br />_Owned b e <br />----------------------------- <br />- _____________ Licensee <br />Application and Connection by <br />Remarks ------------------ <br />Depth of Sewer at Connection <br />r_,--------------- <br />_____________ ----___ <br />/ I I <br />Connection made the ___ _ --dayof-- _ <br />_-------- 191 Examined and Approved by .-__-- -- -- - - <br />,. City Engineer. <br />/ _ ___Supt. of Streets and Sewers Q67EG <br />/ / ---Inspector. By. _ _- <br />