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Location 48 blai:e H08.d
Smice No.~t288
?61'3
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Amount
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DATE :.-~/•
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Address
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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS.,.
,v'J ~-WATER DIVISION
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sketch of Service Here
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The undersigned apPlies'fora SUPP1Y~~f wa~e;at No.If 61~.t ;£{"tt..and hereby agrees to
comply "ith the rules and regulations as now,or at any future tim€,establislled by the Board of Selectmen.
~~~o-€.JAm't.of Estimate $yO -
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Connection made in Street.
RemUl'ks: