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-�j v °--� TH�'�ITY OF EVER�T'T <br />Date�L'a�/ - / � ... <br />.. <br />Skatch of Pzoposed Sewer Connection toz Building Situated on Lot. _ ✓� --_ __ _ Block_ _"'-'-�""'� ''�'--' <br />...,.� � �� ��_ � -�-� - <br />Diviaion or Additio�_-_r ' L�1��11,�/'S �1� �Q - �'-- -- ---- --- <br />_�-� .. / <br />No._ -', ;y_ ^ -�Js � i �Gl�.— - — - - -Owned by_ �.%�l. t 5 _ �.I !'O�-r — - - <br />Application a Connection by —�,��� �LiC1.G�/_—_-___- -- _- _ Licensee <br />Rem�ke:_�� _ �`�K�T�— - — - --- -- - - -- — <br />Dep16 of S�wer at Cannecllon � I I � <br />�� <br />����'� <br />, ,. <br />/ c.�,��_�.e�.... � <br />� �,�'l � <br />L�� �etii,ttu_ur-�-- <br />l��" li c1�.1.. �}�-t.c;�_e�tt Sl.u.c. .S ' <br />•�.x.x� R-t.��:_ .l�c-u+-¢-. • <br />�, � <br />i � ;�; <br />4 d. . �. � �.�ur�, ��u: �„ �: ��, <br />�,�. <br />� l ' _.,: <br />a �:.a_. c hA.�..�." !'• <br />�,. <br />"�a s�/e � <br />� �" I <br />l o �k I2"l,t � <br />Connectiot:}-mJade the_ -- __day oL _- � <br /><.LL �-Ku. <br />� <br />J <br />c <br />� <br />� <br />W <br />�Q <br />�_ <br />� <br />�l ` , <br />19__:--. Examined and Approved by_ -> ��.! �:�-- - <br />� � �C(ty Enginect <br />______ .__� — - — Supi. ol Sl�eele and Sewen Hy_._ _/iLi.f1� �� ' <br />By_ _ ' �_` � `iS;.�.� —. _ Inepactor 1JJ20 � __—.—_ _—__._—._—_ <br />