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.� VER.ETT <br />Sketch of Proposed Sewer Connection for Building SituaL•d on Lot ------- Z-------- %2_-________ <br />------ - Block_________________________ <br />DivSion or Addition-Y-- - -----'----------------- ---------------------------------------- <br />------------- �----- -- ---------------Owned <br />by - `- ----------------------------- - - ----- <br />Application and Connection b -------------- /------------------------------ Licensee <br />Remarks ------------------------------------------------------------------------------------------- <br />---------------- <br />Depth of Sewer at Connection I I <br />Connection made the -__ r _day�__- 191. j Examined and Approved by <br />____�i1/ •_�CLt _ _ _ Sup! f Streets and Sewers 06591 I 'I City Engineer. <br />Bya--' a Ins ector, By— -------------------- <br />