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HomeMy WebLinkAboutFULLER RD 36•Name Address 3dward palmer Service No. 'i Location ;3 6 T'1~_.!..03 _:=t.e G_2. Kind "f PiII"Size Size of Main Location ;:;-JC ;:~.S '-l 0;:::c '7.'~,··v 30 "ro ,Od ~1~; 221 8E:- (~;(J5 Amount 'r! -~:'.-'-.'/~. Dato€' 1 :1 21 .1 ...i.~.Li I i TotalAmount _,7./.::!.u......,- Lab"r lC~~- , Material 1 J t''1,'± Dat€ • • Jl;_=-• 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 regulations as now,or at any future time,established by the Board of Selectmen. !,Ii!LL- Am't.of Estimate $ Am·t.Paid S _ Builder _ Owner Address Sketch of S~nice Here I I I I I !I i i iil'-L+-: !-=r I I !I I i • Connection made in Street. Remarks: Work completed _1"•