HomeMy WebLinkAboutBERTWELL RD 35Name
Address
Service No•.2.:r?
Location ..35 Bs-,.-/Nel/Rc/
Date
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Kind of Pipe
Repair-Renewal-Xew Service
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Total !I Date
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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
WATER DIVISION
The undersigned applies for a supply of water at No.St.and hereby agrees to
comply with the rules and regulations as now,or at any future time,established by the Board of Selectmen.
Am't.of Estimate $_
Am't.Paid $_
O",mer
Address
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Sketch (If Service Here •
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Remarks:
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de in t3LA-1,.."I -~~r.:l c(_Street.Work completed 19 •