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�j <br />4 <br />f <br />� ' <br />� <br />� <br />< <br />Form No. 14. <br />Cn <br />TO THG SLiFERiNTIihDF.\T OR 7'HR PVPRLTT \PATF.R CO\1P:17iY: <br />/� nnNi�n��on �o��� /...�:.. <br />��.:....f..'��.I/�:."..... ... � .�.r..:>1�.i1�3tSeC:. <br />�.� .... <br />Pverett ...............:. ' �X " %. , i; ;J .:. <br />..r.�.::.' .:...:......... 1p0 < <br />f here6y npplp (or the unr o[ y���.� in nccordnnce �cith thc ruiea nml rrsulntlons nt U�e Grerelt Nnter Cnmpnnp, nnd request <br />thaC a..1�'�,/,,,�nch tnn Le inse�ted In th� mnin nt t6r pinrr nbm�r ��n; � <br />� . d. <br />The �piumbcr x•ho a•III dn IDp n•ork is .................. <br />' ..................... .................................... <br />The oa•ner of Ihe premises IS .....................�: `. . ...•.......... <br />. t. -..:..y ................ .................................... . <br />The nBenilx ............................. . ............. ' <br />................................... <br />...................... <br />.............. .............. <br />e tennnt is ............................ . <br />.................. <br />....... ......... ............... <br />..................... . <br />�e water rrnt slmnlJ hc chnrgeii to ................ � ............. <br />. . . ...............�� ............. <br />(Sce Oti�cr SIdc1. Si�;nwl.� :...........:. � ....... . . <br />; ....:...�' - '.........;..i.:... <br />- � � � �. APpI nnl. <br />- SL�t'..L,l.' 'ti �;l-t.-(: r...'/ r- <br />