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Curd <br />Water <br />Property <br />lApplication__! �yi�v�j �L%r_______________ <br />Entered ----------- �-_-_? _____, 19_ <br />Book No... _ _ ` -0 - - -`� <br />------------ <br />By------ ----------------------- <br />LotNo. .................................. <br />BlockNo . ................................ <br />Addition ................................. <br />Distance A ..... ...-._F. <br />�. D........ <br />.... Ft. .............. <br />Im <br />o <br />Size of Connertlon. <br />....................._ <br />Date of Installation ................... <br />C........ <br />X........ D.----..> <br />Li--` .. <br />Name of Street____ _______________________ <br />Line <br />Main <br />