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THE CITY OF EVEREI r , <br />Date. <br />Sketch of Proposed Sewer Congr� '.on for Building Situated on Lot <br />Division or Addition_ _� _.. ;iL .as _ _Block <br />No.__—S.I_L _- �TH T: Ownedby_— <br />Application and Connection by ,SA ", — <br />Depth of Sewer at Conaecn00 I I I <br />Tr' CbWW 4 4rrJ�Y� [.G <br />UJ d t.t,-�� <br />Connection made the. -day of_ _ --18 6 f , Examined and Approved by_ <br />_ Cly Eogloaar <br />__ 6up1. of 8aeele aed Sewm By.__. <br />ran <br />er -----'{3052 /.y <br />---- ------fir - <br />