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C <br />� / fG��l f/, /,.. Street. <br />3 <br />i:ccret[,........... <br />4t'7� .• . � .. IL ........ <br />.•TO THr SUP13r INTRNDLNT Or THE Bl'ERETT WATER CO\IPAN\ : � and request <br />�e chy�PP1y for tha 'nee of wat^T In accordance with the roles and rrg•tlntlons o[ the licerell Water ,n:•�Dnn., <br />thnl A+ ..•Inch tap be 'nssertet In the in at the glare box-, toted. ••.. •.•••••••• <br />�w W............................................... <br />The Vh tuber w•bo will do mr work Is... �C� �� ............................ ....... .............. <br />,V <br />Tile owner of the Premises la ............ ................... .... .I............ <br />.......................................... <br />ThenReni. Is .. ..... ..................... .............. . <br />Thetennnt is . ........ ................... ...... ......... ..... ,....... .............. <br />The wnt(r rent should be charged to ..................... %••. •L ..... plican. <br />�Signec ..... r�PPllennl. <br />(See other Side). <br />.Form No. 14. <br />