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HomeMy WebLinkAboutMASS AVE 56Address Kind of Pipe '~"_"._.__,,.,_.....~~"''"_.-~•.__"h"-._''',~~.•"._~_Size S~rvic;e No. Size of Main ~ocation Date .:o.....bJJ.:.~ ..~. Ma'terial Amount Total Date Amount Labor ".--_..__....__"_..•1t•..._._.- .._-----tt------+- ....,-----+---tt------+---+t-----+--+--------------Ir-----t--- DATE----------eTOWNOFLEXINGTON-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 "...: 'I ~ r-I-\1) '"~.... ~~.... ~~... 1"ro .t"~.I~J/r , L Connection made in Street. Remarks: Work completed _19