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-,: i <br />THE ITY OF EVERL IT Date �— <br />Sketch of proposed Sower Connection for Building Situated on Lot_--5� ---- <br />_Block <br />Division or Addit1on___'1_/1 <br />/'i? o z dl d/ i-1 — —Owned by ----- <br />Application and Connection <br />Depth of Sewer at comecnan <br />_J _-------_-- ---Licensee <br />r <br />t/ I -• <br />- <br />st da of � �' *- - --- -19-� �__. Examined and Approved by _ EagWs.r <br />Connection made the. - Y � Y <br />�•,s,G.,L1���( _ Supt. of Streets and Ss+ven By. -f r <br />BY _ �i _. Inspector <br />