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Application. <br />V _r_______ <br />Entered____________/------ <br />Book No ------ ~ <br />BY-------------------� --------------- <br />LotNo. -------- .__.________-_.____._.._ <br />Block No ------------- ------------ ----. <br />Addition --------------------- --------- <br />Distance A. ------ Ft..--......... _In. <br />o <br />Ft.` <br />Ec <br />z: <br />Size of Ccnnecdon------------------------ <br />Date of Installation_______________________ <br />Ptoperty -------- C-------- X _._.___ D.------- > I Line <br />-------- <br />A <br />t <br />t <br />y.TOP 9-0- <br />Curb <br />— <br />Line <br />(A) <br />V <br />Water <br />Main <br />Name of Street------------ ------------ ----- <br />