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THE CITY OF EVERETT <br />tlI Sketch of Proposed Sewer-onnection for [3uil/}ling Situated on Lot // <br />Block _aQ <br />Division orAdditio_n__ <br />Application and Connection by____ <br />Remarks:__ _ <br />Depth of Sewer at Connection <br />Connection made the <br />By <br />7 <br />Owned by <br />Licensee <br />L. <br />City Engineer. <br />7 Ll ! ""`• _.Inspector:.. <br />dayof ]91 _.- Examined and Approved by <br />---- -Supt. of Streets and ` Hers Its. <br />