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d <br />THE CITY OF EVERETT <br />Date <br />Sketc of Proposed Sewer Connection for Building , ituated on Lot— q <br />Division or Addition_ _ _ <br />,f-/ - - -- -- - —Block No. ->� f-Z Owned by. <br />C G,1 tir} <br />Application aid Connection by. <br />Aemonks:_ _. — -- — � �/� — ----Rec. #_.�a+�- <br />Depth of Serer at Connection I I I <br />.I <br />-> <br />Connection made the -- day of.._ <br />Br <br />,-/y-Zk l <br />-19(2 Examined and Approved by__ > _COf__QAA/ <br />City Engineer <br />Supl. of Streels and Seven By_ _ _ <br />Inspector 30'C19 <br />