HomeMy WebLinkAboutDEE RD 11•Name
Address
Kind of Pipe
Repair-Renewal-New Service
Location //P~e ~d
Size
Service No.7/~
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Size of Main
Location
Date-
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•
)faterial
Labor
AmQWlt 'II',
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Total Date Amount
DATE 4t
TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS·
WATER DIVISION
The undersigned applies for a supply of water at Ko.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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IL JJ-JU-Oi d....
Builder _
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Sketch of Service Here
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Connection made in ~..JLL...Ci~ci...Street.,
Remarks:
Work completed _19 •\