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\f'.ii'Servfee No.59 6717
Size Size of Main
Location
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Date Material Amount Total Date ADlount
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1 _i ft Str.1ltht 'tail Plece 118
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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 ..
Sketch of Service Here
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Connection made in .Street.
Remarks:
Work completed 19