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Sketclt of Proposed Sewer ComiecNon io- Building Siluated on Lot_.___..__._____________________ Blocic__________ i <br />Division or Additio _____ <br />� -'-------_..- ---.. <br />-------- - <br />_ ----- ------------------------------------- <br />------------ <br />No.---------------------------'---- . ----'---O��medb ' <br />-----=---- <br />---- <br />------------------------------------------------- <br />AppliGltion and connection by_______ �___` <br />- - ----- <br />------------- ------ �-�- ---------- Licensee <br />------------ ------------ <br />Remarks------------------------------------ <br />------------ ------- <br />---------------------------- - - <br />Depth of Sewer at Connection � �^ I i ' <br />II � � <br />I <br />� � I I I I <br />Connection made the_ �G__day of___��L =(J___ 191�.. Examinednndapprovedby_�_t___�_ �\.___ <br />/f � /.,J� (y n . � . . ,: � - - ----- Ctty En�inccr-- <br />�-- ��-�- J L'---� �a.l.�Z-r-.� -- --- S��pt. of Streets nnd Sctvers ���g�3 ' -�� i- <br />. '�-=-- �--� <br />j --- _ —..._. _ <br />� <br />�BY---F�r � 1_- (]� s-.__ ��*�- --- ----- Insi�ector <br />�; -- �---------- ---__. <br />