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���� ��.��� O�� ��� i��nE�r�� <br />- <br />Slcetch of Proposed Sewer Connect;on for Building Situnted on Lot___1_�__"_ : ' <br />---1----- ----Block-------`—'--- <br />------- ----- <br />Divi:�ion or Addition_____�,__._�:____: - + ! , <br />---`-------------- _ ____ <br />_ /j ------------------------------ <br />No. `�ti ""' `� :7 �. E�F� ------------------------- <br />,.. <br />-- �----===— ' O�tined by <br />--------� � <br />------- - ----------------- --- ' , <br />— — ----------- --------'�----�-----__ .--�"„_ <br />----- - <br />Application and connection b � , - - ' '^' <br />, y---=- � =-�-- �----�-' --- ` ' t_ <br />, � ---- ---- --- - <br />-- -------- Licensee <br />------------------------ - <br />, 2;u�-•' ---------------- <br />--------------------------- -- <br />- ---- -- <br />_ ------------ <br />- - --------------- -- — <br />Depth of Sewer at Conne�tion � I I I !��_I � <br />� � �j,_ , _ <br />f I- , . , <br />I- -.�.�? ___._. <br />�r <br />--- _ ii . .. ( . . . .. <br />� �!� � o82�s � � <br />Co�mection made the_______day of____ _________ 1�J1___ ElxaminedandapprovedUy________ <br />- - ----- -- - -- -.--- <br />City Enyineer <br />----------------__ --___-_____ .Supt. of Strcet� and Sewers <br />BY------------ ----- Snspector <br />BY-- _ _--- <br />