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THE CITY OF EVERETT /111 <br />d Loth ✓ — Block <br />Sketch of Proposed Sewer Connect) for Building Situate oil�X'- - — <br />Division or Addition —_—- <br />No. __. <br />Application and Connection by _- ---- <br />Remarks : _----- — -- <br />Depth of Sewer at Connection J <br />I <br />t <br />Ownid by <br />--Licensee <br />I <br />day of--f`/���` 1Vz�;• Examined and Approved by <br />— -i- <br />Connection made the ->� cit) Gngfneer. <br />--Supt. of Streets and Sewers. �)'---------- ---� --- "— <br />�Jr` �'�-•-�.~y.+-Inspector. <br />f <br />