HomeMy WebLinkAboutFULLER RD 36•Name
Address
3dward palmer Service No.
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Location ;3 6 T'1~_.!..03 _:=t.e G_2.
Kind "f PiII"Size Size of Main
Location
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Dat€
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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.
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Am't.of Estimate $
Am·t.Paid S _
Builder _
Owner
Address
Sketch of S~nice Here
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Connection made in Street.
Remarks:
Work completed _1"•