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THE CITY OF LVERETT <br />Sketch of Proposed 14 .wer Connection for <br />Division or Addition-_ ---- <br />C <br />Situated on Lot_/_e ' / <br />No. i i : — <br />/i <br />Application and Connection by{✓ --- <br />Remarks : --- -- — — <br />Depth of Sewer at Connection <br />Owned by._AA!_.1=-C <br />Block _�5� <br />Connection made the %`� day oL= = = — _192- Examined and Approved by--. City Engineer. <br />tt. of Streets and Sewers. Bp---- - - <br />--(� Inspector. <br />6r-- <br />