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' F 3o•�q-s" <br />i,/ UtTY OF EV 1h1%,j0TT <br />)/7 33 - S <br />----------------- Block--- <br />Sketch of Proposed Sewer Connection for Building Situated on Lot --- Y-_______------------------ <br />------- <br />Division or Addition _[:---`-LL- �1----�'--------------- ---------------------------------- -- <br />No, = - �- r --------/---------- -- -- CwnedbY--------- ----` -- --=1 _ -- ---- ---- ----- --- <br />------ J <br />:� .�; <br />n 33 5% 1 <br />Applicati n and connection by --- <br />_____________ <br /><:. ; , ; ,',-------------------- Licensee <br />Remarks ------- ----- -- ----------------------------------------------------------- <br />-- <br />-------------- -------------------------- <br />Depth er at Connection <br />4- <br />J <br />D <br />+- <br />�n <br />1 <br />Connection made <br />By- <br />J <br />r� I loop'! I <br />he--- day of---- `y' - Examined and approved by-------- <br />City Engineer <br />--Supt. of Streets and Sewers B A � � = --- <br />---�--+-�y=Zi----Inspector---Z1'--------- <br />