HomeMy WebLinkAboutHASKEL AVE 29Location
Service No./.2/.5"•Name
Address
Kind of Pipe
.Renewal-New ServiceRepalr-
Location
Size
-/!3 1--1')
29 dJ'/e//ifl
Size of Main
Date I )lateri"al
i II,
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-Labor
Ainount
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III
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Total II
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Date
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DATE ----,
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS •
WATER DIVISION
The undersigned applies for a supply of water at ND.St.and hereby agrees to
comply with the rules and regulations as now,OJ'at any future time,established by the Board of Selectmen.
Am't.of Estimate $_
Am't.Paid $_
Owner
Address 21'S ,~~~o-¥L.)+~.{:~
•
•
19
Sketch of Senice Here
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BuildeT _
Connection made in )V"C<4..AA".t..J...Street.8 t·Work completed _
Remarks: