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I°' TH._ CITY OF EVEKZ"TT Date <br />Sketch of Proposed Sewer Connection for Building Situated on Lot— ff !F' Block -- <br />Division or Addition__— <br />No.--- - r�� J CC• - - -Owned by Ful�.i r-,ef� - <br />Application and Connection by t r 'rl �-� '� • 'i Iy" - -Licensee <br />Remarks: <br />' Depth of Sewer at connection I I mow— I I <br />• 16� ��.11 It�.� <br />o. rr <br />�10Aj:z <br />b" Q's <br />q-" C s P ' . -k, _A_ to. <br />��i�...� ill' W,�i'- ,•� <br />Connection de the 3 day of is <br />r <br />-Supt. of Streets and SewerBy _An.pdcrl <br />ry 'vy S f <br />i <br />xnmined and ApprgZed by <br />Ity Engineer <br />e By /_ L G,7i aA""' <br />IF <br />(� UU pp A <br />4 <br />6 <br />