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Lexington,Mass.
Com.Saptember 2~-.L.l;r.9J.+119;tL ..::Lo=ea=:;:t;::,:io=n:...-.-__-.,..._
Kind of Pipe
nate Material Amount
Size
Total nate
,Size of Main
Amonnt
..J.n1 1"'.t liD Labor __'~..':t~2 ~~\J""u "ir ~~.1_-",,(J ../11 1011
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"1 -Itt I x 3/4"C Union (2pts 113
1 _Bo'll &~nd ':l o~
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Labor
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DATcE ...........,.,.;........,-._
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
WATEI DIVISION
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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 ..
..
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed 19
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