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THE G1 TY OF EVER /!. <br />J Date" <br />jj� � <br />Sketch of Propdsed Sewer Ccnnection for Building Situated on Lot — — — <br />Division or Addition—¢i _-- - "�`� ( ___ _Blo — -- <br />`�% s _Ownedby_�- — <br />No.— Y t — <br />Application and Connection by <br />Dopth of Sawar at Cnnneetion <br />Connection made the Q_ day oL— — 19_—. Examined and Approved by -- <br />_`•pr 'Ciy Engineer <br />_ Sup'. of Streets and Sewers By—_.-.—._--.—� <br />2922 <br />2 9 �. 4 3 <br />