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Address
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1
DATE •
TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
WATER DIVISION
The undersigned applies for a snpply of water at K o.St.and hereby agrees to
comply with the ntles and regulations as now,or at an,'future time,established by the Board of Selectmen.
--Y-'-TI-I ,
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=1-1-+'='r r~±±J=:j=±:frr:==r~~~~-~~~~'~----;.vO]rb
Work completed ~_Street.Connection made in-------W&;,-'f''----.
Remarks:
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Am't.of E,timate $_
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Builder _
Owner
Address
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19
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