HomeMy WebLinkAboutBRIGGS RD 3HaU!~JPlllil
A.Dav'd Bjorkgren•Name
Address
Location 3 Briggs Road
Sen-ice No.~~//
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Kind of Pipe
Repair-Renewal-New Sen-ice
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Size Size of Main
Location
Amount
1:0/&-0 i
3:07
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DATE •
TOWN OF LEXINGTON-BOARD OF PUBLlC WORKS
WATER DIVISION
The under3igned applies for a suppl,.,of water at No.-e-Y f.)~{/Lr:1 St.and hereby agrees to
comply with the rules and regulations as now,or at any futme tirne~~l1Ed by the Board of Selectmen.
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Connection made in Street,
nemal~ks:
•
•19'"York completed_
~7;?f,":r~Ll..,.
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Address
Owner
Sketch of Service Here
Builder tl ,jJ ~
Am't,of Estimate $,~--,---_
Am't.Paid $_