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Application _...-22 7-__----___ <br />Entered. -'-------------- SF=1- __, 19a, <br />B B <br />ook No.. <br />BY-------'--------------------- <br />LotNo. -."----_------------------ ------ <br />Block No -----'-'----' <br />- .Addition...------- ---.- ............. <br />i <br />Distance A ............ Fe______________ In. <br />, <br />Y <br />D....... .. Ft ............... I. o i <br />E , <br />E <br />7 Si:c of Connection ......... _.............. Z , <br />Date of Installation_____________ <br />k. <br />2roperty <-------- C------- _ X--------- D-------- > Line <br />Curlr <br />Water <br />Name of Street <br />Line <br />Main <br />