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'. THE C. FY OF EVERE T <br />Da1e�s d <br />Proposed Sewer ConrLectioryfornBuilding <br />Situated on Lol _ _ _ _ _ Block_ <br />Division or Addition_ - _— �_ CrN� WWI_�/ _ <br />/5-27-7s sf <br />/1", No.- -- -- -- Owned by- ---- - - X. ,ZJ� _.w _ - ---- <br />Application and <br />Connection by E,2W <br />Remarks:��_.%L%ti <br />Depth of Sewer at connedlan I I <br />i. T <br />fo�.�e�cfv- .de�.,7trtEe . <br />g <br />- Licensee <br />I <br />Connection made the. /7 day of __ 4/91,. .__.__-_.194L : Examined and Approved y-_���IV" <br />City Engineer <br />.----�-- - -_ Supt. of Streets and S <br />ewer By <br />By _-2-s`�-/-(!?-t-r: Inspector G 3 0 Q - - -- <br />