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THE "iTY OF EVERE-1 9/r,I �g ,,•�; <br />Date <br />- `�- <br />Sketch of Proposed Sewer Connection for Building Situated on Lot__ `_' --_ Block -- - -- <br />Division or Addition';-� - - , ---- - — <br />No. i�f.] cC S I. -- ---- Owned by t�l7� "H �u — <br />censee <br />Application and Connection by - ) / SITi• n/� � • <br />�1 r �, 'L' ! /• h,7L; • n� f7 [:.JSA J zo. �� D <br />Remarks:__-/1__'__- -- -- — <br />Depth of Sewer at Conneclton I I I <br />PabhrZ' <br />Connection mad t e'-J - ay oL—� W ' <br />;upt, of Streets and Sewc•e <br />Examined and Approved by_ - 01 <br />c: Eng no, <br />By - <br />BY -+--- 17 3 21 <br />�` t•Nr N N•N[VV t0 <br />