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,f <br />Application 0. ..... <br />Entered <br />took No. <br />BY <br />LotNo ....... ...... Z................................................ Block No_....... ...... Addition . ...... ............................................................. <br />Distance A .... Al ............... Ft ........................... In. v <br />B...,17 ... ........... Ft ........ ...... ....... In. <br />C.... .. & .... ........... rt ...... 1/ ........... . Ir" <br />ED .............................. I'l .................... ]n E <br />Z <br />m m <br />Z <br />Size of Connection ....... ........ ........................... . <br />All <br />Date of InsI3113tion ..... ........... 10.�.nzfrIj ...... ... <br />Property.. ........ C ...... ........... X .................. D ........ ..... > Lille ....... <br />Stop FT]Cock <br />Curb <br />Water Main <br />Name of Street <br />