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N. <br />z <br />Application ...... <br />Entered .................. <br />. /3- <br />........ ........................ <br />-16 - / Z-- <br />BookNo. ........................... <br />....................... <br />174..1.. <br />By-- .... .................... <br />....... ...... <br />Lot No, <br />Block No. <br />Addition ... . ............. ................... <br />Distance A.. _.....-Ft.... <br />_:?_..........In. <br />B ... <br />rt. <br />in. <br />C... <br />In. <br />D ... <br />In. <br />Size of Connection,. <br />Date of Installation <br />z7-.m..-a.I(^.. <br />-C ................ X ................ D- ......... <br />born I COCK <br />IIAIIQ , - .. .. <br />G al'!:2. <br />Curb ..Line <br />(A) <br />Water C. Main <br />Name of Street .... 7,— <br />... ....... ........... ....... <br />