HomeMy WebLinkAboutMASS AVE 2117Date
Kind of Pipe
.Renewal-New ServiceRepwr-
1·,Ma.terial
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Amount
Locatioll.
Size
Total
Service No./?Cl..3
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Size of Main
Location
Date
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Amount
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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.
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Am't.of Estimate $ _
Am't.Paid $~
Builder _
Owner
Address
Sketch of Service Here
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Connection made in Street.
Remarks:
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