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THE GITY O� EVER.ETT <br />Slcetch ct Proposed Sewer Cmmecbion for Building uituated on I.ot_____ _-______.___________ Bloc]c_________________________ <br />Division or Addition----=---=-----------=`--�-------------- -----------=--=-------------------------- - <br />No. -------=-----------=-------------------------- --Owned Uy ---------- ---- � -------/ -�-� �----� , . <br />Application and Connection Uy------..---------------:.--------- ------------------------------------ Licensee <br />Remarks ----------------- <br />Depth of Sewer at Conneclion � I I �— <br />i <br />� <br />_ <br />, � � n ( I <br />Connectionmldetl�e .�.�_�;___d:�yof_______�_.:________191:,_ Esamined ai:d Approved U� .. _____ - � � � <br />-- ------`----_._..-- <br />_Supt. of Streets nnd Sewers C e`� 1 ; Ci6y Engineer. <br />B3 --- �--------�-----�-c`._-+----Inspector. Ry — — --I---------`- — - <br />� <br />