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I Lexington,Mass.Location 7 Jackson Court ~,"41 !
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Labor '.t~110
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...
DATE ~~1
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.
Am't of Estimate $..
Am't Paid $.
Builder .
Owner ..
Address .
..~o.o.o..
Sketch of Service Here
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Connection made in ..Street.
Remarks:
Work completed 19