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9 <br />Ti�E �I'��' Q�' EV'EgZ.�TT <br />Skcich oI Proposed Scwcr Connection Ior Building Situated on Lot_ ____ ::___ ___ Block_.�_: <br />Division or Addiliun - -- - . -- - -- <br />.. _�.�'__ , . . , , . �....: Owned by_ _ '. <br />, : . , <br />No. • .._.._ »-�— <br />—� -- --_ _ _._ <br />Application and conncction by � �• — J <br />aepth oE Sewer at Connection � � � I I ` <br />I I <br />-- - i <br />i � � ��:._ <br />9 <br />I_. � � , , i <br />� <br />� f I�I � <br />Connection madc the�day of � 19�i� Examined and approved by <br />/ � / <br />� �� �,- ��� �''1 �L �C�� Supt. of Streets and Sewcrs � S � $ t3 By <br />�j / l l�' � �� � ' i r'�" `— -- --_ lnspecror. <br />�� � �-- --- <br />� <br />Ci�y Engine.er <br />