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-- ------- --- --- <br /> a � i�� -- ---� <br /> . Form No. 11. � � <br /> • PPilcntlon No.�.�.�,�7„ <br /> � � Nn..... .. . ........ .. ... Bt ee. <br /> . ..................... <br /> iliveretL � ........ � � <br /> . ' TO THC 9UPE/RINTENDF,NT OF THE F,��ERETT ���,\TI•:R CO\IPANY: �' 19 <br /> . I hg �eDPly tor the usr o( u•nter in accordance with the ruies nnd regnlntlons o[ the F.�•erett�peter Company�,an,�.reyuexl <br /> thet n..�,,, ,,,�pch tflp 6e tnserted In the lll���ryryry��� <br /> q /� �//p_lar nbnY� stated. . <br /> . The pin Mr who wiil dn my a•ork ix .../,'`�,w�ly�N <br /> . . • '� : � �.................... .................................... � <br /> The uwne�et the premfaen is.�-,,,,,,, y <br /> .c r i3,�,i .... ....... <br /> r, ................................ .............................. � <br /> �_ . .............. <br /> i ��:e aBencis...... ......,................ ........................ <br /> : ............ .............................I... .. <br /> I °i'he tennntle............ � � .. .............. <br /> .............�/ ..�.. <br /> .............................�.. <br /> h.The w•nter rent ahonld be cherRed to....,�!� , � �� <br /> �V � . ....1..................... . � <br /> �• .... <br /> � ... .............• <br /> ............................ <br /> I .�,:.!(9cc Othrr 9(del. 9lgnmi......�. � �-�'"`ti <br /> y.r. . .............�.. <br /> .................�.. <br /> •�..... <br /> �j?tyU.(,��Q AnPlican� <br /> �' <br /> I <br /> i <br />