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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,establisbed by the Board of Selectmen.
Arn't of Estimate $.
Arn't Paid $.
Builder .
Owner ..
Address .
Sketch of Service Here
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Connection made in Street.
Remarks:
1.-.
Work completed 19