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THE C., TY OF EVEREI <br />Fketch of Proposed Sewer Cognac nor Building Sitpated on Lot <br />/d � . <br />Date <br />7! — <br />Division or Addition "4 _ _B ock-- <br />--- <br />No._ 1�"�D �. /-- --�-- — ..Owned b40, <br />.,.- ,fit t �-L---- ----- — — - <br />Application and Connection by�_ls.�_jPE — - 5 o N <br />Remarks:_ Q m. — ---- Rec. # — <br />Depth of See!e, at Co"Wlon I <br />�I, <br />RZ.u.•w to <br />/7 <br />Connection made the day of <br />By. --'-- <br />19 �S. Examined and Appzovod by IL r / <br />Clry EnglnMt <br />._ Gapl. of Street, and Sewers By-- <br />--.ttupMat 25164' <br />