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THE `;i N OF EVERE . � <br /> Date.-Al <br /> Sketch of Proposed Sewer ConnecUo for Building Situated on Lot F'7� W+�� '? Block--- d_/_ <br /> " —/:Itw 4M `#`/ ✓a S <br /> Division or AddltIonu_ _ <br /> No._ <br /> Licensee <br /> Application and Connection by_ `' <br /> Remarks:—_ _ <br /> Depth of Sowot at Connoctlon I <br /> 4 d <br /> I_ I <br /> rt <br /> Connection made the. " --day of-= Or "' —19 y • Examined and ApproveCity— «r <br /> Supt. of Streets and <br /> r�Bowee s By - -- <br /> Inopectof 1G J <br />