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V <br />THE CITY OF EVERE"i F Date zl" i <br />Sketch of Proposed Sewer Connection for Building Situated on Lot_-- _ Block____ <br />Division /or Addition__ <br />No.—/�QQ'`/� ST. ----Owned by_.�� A--_—��— — ---- <br />Application and Connection by "% r 7//c r" ! 1 %� �-G--------7--- -- —licensee <br />Remarks:____..,_ e LdL4 b/ <br />Depth of Sewer at Connecttfon I I I <br />cep v3 <br />1 4----- <br />Connection made the., �'A'� day oL—. -- .19— Examined and Approved by_% CW Engineer <br />__�'_ �______Supt. of Streets and Sewers <br />BY Inspector 21363 <br />