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L� <br />Property <br />Curb -- <br />W1 <br />Applicat.on............................................ <br />Entered <br />Book 1� <br />By...... <br />LotNo ........................................................... <br />BlockNo . ................................................... <br />Addition........................................................ <br />Distance A ................... <br />Ft ......................... <br />In. <br />B........... ........ <br />Ft ......................... <br />In. <br />C.................... <br />Ft ......................... <br />In. <br />D.................... <br />Ft ............ <br />... . ....... In. <br />Size of Connection ................... <br />. ............. .... <br />Date of Installation <br />.................................... <br />E <br />M <br />2 <br />C_ X D ... ......... > I Line.................. <br />Name of Street........... <br />Line <br />I <br />