HomeMy WebLinkAboutLOCUST AVE 28.......DATE---------~e
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 $_
Builder _
Owner
Address
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed _19
NameAddr~ss2'6 l0~0*~c\
Kind of Pipe COppe \"
Repair~~New Service
Location
S·:1.'1lze
Service No./¥~J>.
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28/o~u.$f /lye.
I "Size of Main \p
Location
Date Material
~I j".JO.,.Coppe\
Labor
Amount .Total Date Amount