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i <br /> THE( .ITY OF EVERE ;"T <br /> Date- <br /> Lot <br /> of Proposed Sewer connection !vr Building Situated on <br /> Sketch <br /> / r � Bla• — <br /> 00 <br /> Division or Addlfl em <br /> P, /s — <br /> owned by— <br /> No— <br /> Application and tgnnection b Y—yf x� C•/s a� �s, �• fjs �.4�T ,s�,J /011e�/ <br /> Remarks: <br /> Depth of •Jevlef al C,OeCeC1100 I _ I ` <br /> J f X c(. (, r. toit <br /> 14 !'• <br /> Q-1 <br /> ' •wcw� w I tl <br /> pp 1� <br /> to (�.u.c. t�4Q,µ�• ... //ire/til � D <br /> 2f^ <br /> /4 /a <br /> ell �z I <br /> �—r•— <br /> +T <br /> �^-tLu.<• —19.� . Examined and Approved by cuy! Ens <br /> Connection made the .- —day of .._- _ .-- __ _ -y,f <br /> JJ <br /> �!„� " rLt Fi.•L—._—._ Sup,. m Siteoh and Sewers By— <br /> By <br /> -- ---- <br /> By---- E, ..., ___----t"ep.otot 1C•4 ! 2 _-- <br /> . '�. uu•puu <br /> 44. <br /> t <br /> I 1 <br />