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P.O. l5as <br />4L <br />Enteredgew. n .............. <br />19115 <br />Book No. 7 _7 <br />Lot No, ........................... <br />.. ........ <br />BlockNo............./ ............................... <br />Addition.... ............................ <br />Distance A ..... —f ........ Ft.................... :M <br />i,t ..................... "' <br />c.................. Ft ..................... to. <br />D-17-0 ..... Ft .....................in. <br />IV <br />Size of Connection— .;.�..... ........ <br />Date of liustallition.. <br />E <br />Z <br />Property c .... ....... X ............ D > Line ..... . ..... <br />Stop Cock <br />v <br />Water Main <br />Name of Street Kl'ld.l�l <br />