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0 <br />� -� �- -- .. .. .. . . .. ..... ..- . _ . ._. '-. - -._... ._ .—. ._. _ . . . _.—. <br />. .. - -- -- � � --- ---- <br />�// � 7 � <br />Torm No. 1�4. / -� 47 ^ � �31 <br />Applicntlan �o.........�t.... <br />' Nu ..............��.�. 5..��..Lc_.-.e_.� <br />........................ Strcet. <br />� c �� ,,s <br />Ecerett� ............. �....................... 19D � , <br />r <br />�'O THE SUPERiNTPND1iNT OF THE P\'Is'R[iTT. NATisii CO1IPAnY: <br />I <br />I hereby nnply Por tl�e nse of «•nter in xccor�tunre �vith tlin rules and reF��lntions nf the Gverott \F'atcr Compnny, im�l rc�uest <br />•� <br />that n...y. y,.,�nch taP ��� ineerted (n thc main at th� placr nLo��c stnted. <br />� .��D,� -� � <br />T6e blumber who will do m}' work is... r.....�.�:�..��y-z,.�.. r.. ��:.......... 0/ <br />;. ................... ... . ... <br />.�� .... <br />. The mi•ner o[ the premisrs Is......... .�f�-�..�G:L`:..�-t�,«= j.�-......... . � ' <br />/.. ................................... .............. <br />TheeBenr.ls ............................. ..........,ti¢u`.................... .................................... .............. <br />The tenant le ............................ ...........•,�,`g� <br />_ ....................... ................................ ... .............. <br />The watcr rent should I�e charged to ......� .................................. .. . . .............. <br />�x�,l�( /}m� //11pp �, . <br />. ....... <br />Sl�;ne4......Y.,!H •.- ` .� . {- <br />. .. .k..�.. .a... . .............. <br />(See O[hcr Slilel. � ' ......... .......... ApPilcnnt. <br />