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0 <br />0 <br />�_� _«y-� x <br />l a t. �� - - <br />' � ----------. Blocic---�-----------...------ <br />Slcetch of Proposed Sewer Connection for Bwlding Sitnated on Lot_______.._____ <br />Division or Addition------------ � -------`. _---------------------------------------------- <br />_,; -------------Owned by ------------------------- ---------------------- <br />No �� .- . . . _, . _ •_--------�- . . <br />• ---- �: <br />• -"`--'--------�- T----- . , <br />Application and Connection Uy-------------=---'-------=-=-------=------------------------------------------ Licen:,ee <br />Remasks ------------------- <br />Depth of Sewer at Connection <br />/�,;°n :._.-.r� . . i <br />_r. —.____ — <br />--------------------------------- — ---------------------------------------- ---- <br />I I I �� <br />I r ( <br />t__ .. . . � . . . . . . _ —___—!— <br />I J ` : .� � A,J ��� - .� ...,_..�...� <br />! r � jt. <br />��. ��- <br />r� . , .'J-� �-� �1: �I. ,r ... +.(. <br />�.�.; �f <br />-I . - -_ . - . . <br />-I � � I;,. <br />, �� <br />Connectionmadethe___i__�_dayoF_____�_____________191,z= Examined and Approved Uy_______________________---_-�=-- <br />'� ' � Q���O Cit En 'nee^. <br />--------__-'--�----'- `-�------------------Supt.of Streets and Sewers Y 6'i <br />$Y--------------------- '----------Inspector. BY---- I =--;-----------------=-- �-----'-' . <br />.`, .' . �„ <br />