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THE �I% f r��� �VERET"T � . <br />. � � : �,. <br />� �. <br />_ Datef i�::' ::% J ,t <br />_ �, ,/:'. ? <br />Sketch of Proposed Se�.ver Connection [or Buildinq SituaLd on LoL__- __'--__ _ Block—_✓ 'S _ <br />Divieion or Addition 1%•'c`vy f.�=i!/Lr---�r'y. r f✓� ✓�� ' s _ <br />i <br />nt.. :.S(J �,�. .:.�i � %/1 t�tC t�i.ili; �- L�/.� <br />nwnr d by � '' �— <br />Application and Connection <br />��l /i�% .!� r-.' <br />.+.'... i ..[7 • <br />� Aem�ka:------- — --- — -- <br />Deptb ol Sevioc al Comecltor I f,'`I 3� I <br />_— I i —.�G-�-ff't'i;i >,. ��r�1�'.c ( <br />—�� � I <br />� �. . -P;�rtli:: - <br />� <br />Licensee <br />� <br />� <br />/�" <br />/�''yi ;'„� i��,. <br />Connection made the_ _ _ _ _ _. _day of- _. _ . _ _ _—___ _____19—. F.xamined and Aoproved bY_ ; � <br />� y 1 'J . Clty Engineer <br />_ __ __ _. Supl. ol Slreete and Sewen Hy—__-,-v �s__ r_�_rT%✓%�' — <br />� <br />HY_ ._.__—___—____- ---_lnnpeclor <br />,�:,,�. ..,, , ..,,�. �� 153 3 0 <br />