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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 $..
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Sketch of Service Here
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Connection made in .Street.
Remarks:1r"/Ife 141 e,c:L l''Y"O '"_}~/~1'1a iftf T()C t.t"t'b I Cf :3 f
Work completed 19