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�'HE :ITY Oi= E�/ERE"�"T �/��./�� <br />Date <br />Sketch of Proposed Sewer Connection foc Building Situated on Lo�GJ��r _ <br />Division or Additio*� LI ^'��l l'� ��• �'7 f'4"�� <br />II <br />Applicalion and Connecfion <br />Rem�ks: �; '' ��`✓ ° <br />Depth of Sewor al Co�noclion <br />id �,,, �,/, i�, "�.Y <br />Block / <br />by Tfi.>�a��r/`�a�–. <br />rn %h`,o 4; 6 � T� fu _ <br />l..� � <br />� <br />� <br />/-,/ .� <br />Connection made the�day oLt �'_----- 19-='-�- Examined and Approved by__1�52 /�/�� d —_..__ <br />� ,(�/ City Engtneer <br />_Supl. of StmoL+ cnd Sewere By--�-L-/'n ��'���/�--- <br />_ 'l� ! r <br />BY �;_ r� � _��F,���or 3 44 2;? <br />.�u ii�000es i.�e x�x voae� <br />