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THE I.ITY OF EVF_RE'1 f r/ <br />Date � s <br />Sketch of Proposed Sewer nnection f9r Building Situate on Lot.—_ <br />Division or Addition_.__. __ .e-3 _ Block _ <br />No._ _z 3 ;' 3_ —7 3 �( -- --Owned-- <br />Application and Connection by, C G ati4C�' <br />Remarks:_. —__.__- <br />— 4 / / <br />Depth of Sewer at Connection <br />✓7 <br />Connection made the. o_q _day of- 19 G b .Examined and Approved by(fo L ✓ / A) <br />City Cogieser <br />-Supl. of Stnete and Sewen By_ <br />By _ _----'---- ttupWor 27727 / <br />