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Curb <br />Water <br />Application/.. Y - •_ <br />Entered..._ ........__..... /_ ..lS_ _...... 19 _......... <br />Book No.N-- <br />BY._.... ..... <br />Lot No. <br />...................... _ __ <br />Block N, <br />Addition <br />Distance A ._ _Ft. <br />B <br />...... _.... Ft. t <br />.� C__-_..... Fr. <br />... .. _... In. `o <br />,. D........ <br />.._._..R. _.. . in. E <br />Site of Connection Z <br />Date of Installation - <br />Name of Street <br />c <br />F <br />tel _ <br />v <br />Main <br />