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Sketch of Proposed Sewer Connection to, —fling Situated on Lot__________________________ Block-__1 �_____________ <br />Division or Addition --------t--1.--`-- �'� ' --- - -------- --- --- --=--- ---- ------- --- - <br />. Owned b <br />No. _.i_� -----1 (------- -=-�`-t-`�------------ --- y f% .?. Lr.-L ,�2!l/-I------- <br />----------------------r. z---- <br />�''� a'� / -- <br />Application and Connection by____---__! !f_:/�.=-'------=-------i------------------------------------- Licensee <br />Remarks <br />------------------------------------------------------------ <br />Depth of Sewer at Connection <br />Connecti nmade the _ _dayof____!(_u i_---__1915 Examined and Approved by_____c„_.:____________ _ _Z_Y____ <br />-------------Supt. of Streets and Sewers 066611 City Engineer. - <br />✓� 1� Inspector. B - _'- <br />