HomeMy WebLinkAboutBOW ST 72Name
Address
Kind of Pipe Size
Service No.S 6"3
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Size of :l't1ain
Date
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Repair-Renewal-New Service
I Material
Labor
Amount Total
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Date
Location
Amount
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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.
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Am't.of Estimate $_
Am't.Paid $_
Euilder _
Owner
Address
Sketch of Senice Here
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Connection made in Street.
Re-nlarks:
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Work completed _19 •