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0 <br />�I'H� C;I`TY OF ]EVE,R�TT <br />Sketch o( Proposed Sewcr Connection (or Building Situated on Lot z� 3__. <br />Division or Addition— ___ _" ___ _ _ _ <br />I�o.--- 'l_ �' O (.� — � c .tl� � <br />— --- <br />-- ----' Owned by— — _ __ -_ , �. - ._ <br />Application and connection by —_ _ _ <br />Remarks--- ---- ----- ------------ <br />Depth o( Sewer at Connection I <br />J <br />� <br />_ _ _ Block _-- Z. <br />�,��! i I I <br />:censee <br />Connection made 1he� day of_�19�y Examined and approved by_ <br />05037 <br />__ %G.�c_ G������`"� —Supt. o( Streets an� $ewers, By_ <br />' i �'r�o�-�`u ; �/ <br />'�y�-------- �' "'---__—Inspector. , . _.__ _ <br />� � �- i _ . <br />i <br />City Engineer <br />