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- - ___ - -- <br /> � �t - --- • <br /> {�y �- / <br /> Fonn No. :4. " ��� <br /> 3 nnNicauon �o..r:�.s.�('.... <br /> \u..........................'..i.:..ts:_' :.:.......... S[rcel. <br /> 7 � <br /> ...... <br /> ' � I?rerett..✓•?�L ,.td G�l,:�....��.......... 190.� <br /> TO THb; Sl?PP•.RISTGNDP\T OR THi; GVIiRI:TT iP:1TRR COSIP.IRY: <br /> � - I hernuy npply for Lhe nse of �cnter in accnrdnn�r wiU� tl�e rules and regulntinnh o[ the G��erett AVnter Companr;nnd re9ueflt <br /> thal :i'...��:;�...Inch tap br inxrtrd in the ma!n nt the p;n<•e abocn fitr�tt�d. .. � - � <br /> Z. <br /> TPr plumLer �cho vcill do nt}• wm�l: Is......... �<-7 .^vZ'�z� <br /> � �.........�................../. .................................... .............. <br /> Thr ou�nrr of th� ,ri•iniv��a is...............�.-.:/.:.L.i.!...';�-l:��Cr.,.C�.r.......... � <br /> - ......................... .............. <br /> Thc nFi•m iF.................... <br /> ......... ........................ ........... .................................... .............. <br /> The trnantiF.............. .............. <br /> ...............:...:.�.. ..........,- ................. <br /> � �� ................... . <br /> . :� � � .... . <br /> 9'he �er.ter ront shonld he chnrged lo........5...! / �, �'` Y�'(.�:�..�� . • ....... <br /> ...........A....... L.. ........... . ..... <br /> ........ .............. <br /> • � / <br /> .. <br /> . <br /> Qi�ned..... � �/ ��?Y�.o'��� �. <br /> (Sr�� 0!her SideL • ................. . }'..�. r. <br /> . .............. .............. <br /> Appllennt. <br />