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Kind of Pipe Size Size of Main
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TOWN OF LEXINGTON -BOARD OF
WATER DIVISION
DATE!JoU.<3-J9~
PUBLIC WORKS
The undersigned applies for a supply of water at No.It))Ji~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~
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed _19