HomeMy WebLinkAboutGOULD RD 2Service No.
Kind of Pipe Size Size of Main
Amount
/0000
---i ........
.-'--
DATE,_
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
WATEl DIVISION
The undersigned applies for a supply of water at ::-<0 "",.,""".",","St.and hereby agrees tD
comply with the rules and regulations as now,or at any future time,established by the Board of Selectmen.
Am't of Estimate $.....""...""."...Owner ..","""",..,"",..","""..
Am't Paid $"""..Address '""..,,",,"""..""..
Builder ,", ,.
Sketch uf Service Here
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Connection made in ',""""".""",""'''''',Street.
Remarks:
Work completed """,19