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,,DATE__...,-_
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 .
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Connection made in Street.
Remarks:
Work completed 19