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THE FY OF EVERE T <br />Date—jdY/�/0/ky,/ <br />, <br />Sketch of Proposed Sower Connection for Building Situated on Lot—_ _ .— '�? Block -- <br />Division or Addition_ <br />r / .. i c,� owned by R - t I�1L� �1!/-- <br />N—. <br />/ _ - licensee <br />Application and Connection by_ rft-y�---,1 <br />H//i L- --- — - -- -------------_..------ <br />Depth of Sewer at Cen wdm I <br />E -r °f w28 <br />tit 16Ad"t4d� <br />Connection made the.7-__\{_►day of - <br />By - <br />CAj All <br />19 t-- . Examined and Approved(/b�y_ . �1 n en <br />.. Bupt. of Street. and Sewofs By -� — •`/ <br />Inspector 24599 -- { <br />