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THIZ' �PTY OF EVEN :"_ T <br />14, '4 Date <br />S1r+ch of Proposed Sewer Connection for Building Situated on Lots-3 L 2 __ Block <br />Division or Addition Z 0 oe4 •4 D U_ <br />No. ,? O / 4 2 -- —Owned by CC, FJ.7r_7,y!• �r�YJP) � — -- — <br />Application and Connection b . !U,, ' J %a <br />PP Y - _Licensee <br />Remarks: 'niL�hr/e f, [,.fir.) Je&V ^v r*' -9 f sra �C 2 <br />Depth of Sewer at Connection I <br />r <br />n <br />0 ir <br />6 <br />Connection made the—" -day _day of___19-6. Examined and Approved by_ <br />/ C1 Engineer <br />—__...Supt. of Streets and Sewers Ity_— <br />�" F, /`t I LC !i Lq 9_ <br />,Inspector <br />sea........ • vucu. ee. •en. M. <br />1��19 <br />