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P.O. 1595 <br />A, l )'t�5i.��' <br />Entered <br />. _/X�,8 <br />Lot No . ..................... <br />V .� .__._. .. <br />Block No .................. <br />. `� .�y-......-. . <br />Addition ..................... <br />_.... ......... ... _.. <br />Distance A ...... ?,,9...... Ft.__.. ...... __.._.In. <br />., a ....... ZL........ Ft.....................In. <br />.. C.................. Ft ............. _In. <br />.. D..... /..`}... Ft........... __.-In. <br />ly <br />Site of Connec'ion.............,lSa................ <br />Date of Inatatlation..........4........................ <br />v I., <br />to <br />`o <br />ed <br />T q _1 <br />sJ <br /><- - C--.........g............ D........._.> '4 <br />Property Line ............. <br />A a <br />C <br />/1 <br />StooOCock 1JJ <br />Curb-- - - - — --- Line C <br />r� <br />V <br />Water Main <br />t 77 <br />i <br />Name of Street........ ..................... <br />