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TgIE GITY O�' E�'��I�.E�T <br />Sketuh of Proposed Sewer Coimection for Bnilding iituated on Lot_____ __ ::___________.____ Blocic____�____________________ <br />-- r <br />Biv;si5n or Addition---- y = �= � � -- �=��-----1-- ----- �--------------------------------------------------------- <br />� <br />No. ----------n -----------�-�- �- -------------------Owned by - � C�--��=-- _-----�-=-� �--=��- <br />---'---------- <br />Application and Convection by--------(�=_--.�= '----.-----�-------- '.- ----------- Licensee <br />Remarks � <br />I 2- � <br />________________ J.� �_____________________________________-."_._____________.._____ _______________. <br />Deptl�'of Sewer at Connection I I I � <br />� � <br />_ �_ � `� "`._� <br />- - - -�-- <br />_ _ _� _ ___ _ _ _ __2=1� � <br />. . . . _. . _ _ _. _ _.. . _ _. .. _- ��--- <br />-�, ��,.c _ :� � �� i � � � <br />r � "..:�� I 'r i � <br />Connec�on made theV _�� dtiyof ��=--!?-----197. �:_ Exa,miued nr.d ApnroveQ b�-- �J v1 J•..;.±, .,_ c-'.-_- l"�---- <br />� ��( � C- �, ,� �____. _._Snpt. uf Streets and Sewers o�58� � v ty En�neer. <br />� �; ` - � � . <br />, • <br />gy � �;, : :: t,� (!iy.,�_'\�/t�jcF-----Inspector. Bf- .- ��' :=� c .-�-_.,_ _' , <br />--- - __ ----__ -- <br />i> <br />