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Curl' <br />Water <br />Application.-, s- ..•-------- <br />Entered...___.__ <br />Book No f!r!lW...__... <br />LotNo ................................... <br />BlockNo .............................. .. <br />Addition... .............. ............... <br />Dinanoe A ............ Ft .............. In. <br />B.... ....... Pt. In. <br />C........ ...Ft...............In. <br />" .. <br />Sise of Connection ........................ <br />Date of Inatallntion ....................... <br />Property <........ C........ X........ D.--- ....> <br />UI <br />V <br />u <br />n <br />z <br />Line .......... <br />Name of Street.............................. <br />Line <br />Main <br />