HomeMy WebLinkAboutCENTRE ST•Name
Address
Kind af Pipe
Locatjan
Size
_.•~
Service No.~,,2/
Size of Main
Date
•
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~pair-Renewal-New Service
~laterial
Labor
Amount I
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Total
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Date
Location
Amvunt
-DATE ..
TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
WATER DIVISION
The undersigned applies for a supply of water at Xo.St.and hereby agrees to
comply with the rules and regulations as now,or at any fu ture time,established by the Board of Selectmen.
Am't.of Estimate t;_
Am't.Paid $.~~
Buildcr _
O'i;Iilner
Address
Sketch of Sen-ice Here
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Connection made in ClMAt'\L Street.~t::.Work completed _~_.~~~_
Remarks:
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