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Date
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Total
11-6-50
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Date
•
•
DATE •
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 l'egulations as now,or at any future time,established by the Board of Selectmen.
Am't.of Estimate $_Ownel'
Am't.Paid S _Address
•
•19WOl'k completed
Sketch of Senice Here
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Connection made in Street.
Remarks:
Duilder _