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Form No. 14. WE <br />///LL...... / App •a n 1 /. ..... <br />TO TIiIi SUI'I;RINTE\WENT OF . • • .. • •' , .. • • . 77iE Et'ERGTT tVATER COMPANY; Pverelt.............. .. .. ........ stree <br />t. <br />Y'I eL aDPl1' for the use of w ..190.! <br />A''/ 4 water 10 ACCOFI1AACe with QIP F111e8 Anft Fel{'lliaflOnB of the <br />.•�IIaM �ft t..,l ,.. Inch all be Inserted In the maln at Ule place above stated. <br />ICVPrCtt Water Com puny, and request <br />Tile Pic m ber who will do in <br />Y work <br />The owner of the ..'........... <br />Premises Is...... ....... <br />.. ................... <br />. ............. <br />The ogenl le ... .......... ...., ......... <br />. ................. <br />The tennnt Is..... <br />?he water rent sbould be charged to,.,,, <br />// �! I.1..... ./ ............... .. ............... <br />(Set' Other Side). p ,/ .• 1r ..,.• <br />Signed.. .Lt✓2'Z 4. .../.�. �f ....../.. <br />AnnueA� <br />