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� , � T�'�;� GITY ���'' EVER.�T7'i <br />-; <br />Nketch of Proposed Sewer Connect:on � Building Situated on Lot_ .�_i____r------------------- L.ock_____ ___----�--------_.------ <br />' I <br />Division or Addition_ -----=-�--- � =---`__-------1------ _-----------__---'�----.--------------------------- ----- <br />� � � i�-1 � � , . <br />No.--------_�,i-%/-- —`"�---��------------------Ownadby---- ---t.j-----`---`----------------=-------`- <br />Applicatiou and conneetion by-----=— �---+�-----=-----'-------------------------------------------------------- Licensee <br />v <br />R.emarics ------ --------------------------------------- — --- <br />-------------------------- -- ------ <br />Depth of Sewer at Conne_ticn I I I I I I <br />�i <br />—I <br />Conner.tion made the--;-`---day oi_.--__-- '------- <br />I I <br />f_..__---`-- ' <br />� <br />' Ui7l7�g I � <br />191__.. Examined and approved Uy-----. ------ --- --- -�---- <br />City Engineer <br />-------------------------------Supt. of Streets and Sewers <br />BY._-------------------------- - -- — <br />A ------ Inspector -------------------------------- — ----- - <br />Y---------------------- <br />