HomeMy WebLinkAboutPATRIOTS DR 6Name
Address
{'~tion #:6 Fatri 0 tIs Drive
Service No."=:1~/Po,
.::fI=-t:,.:l.~;;L
Date
Kind of~J:}e
Material Amount
Size
Total Date
Size of Main
Location
Amount
03=-....
<_<.t-~k
"p;
I ;.,
,"I-~~"'-tIl
, ,S_eryice :j.nstalle
by owner)with p rmissio
of Town.
Labor
1-
----,,----'
J
---....,,DATE-------------,e
TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
WATER DIVISION
The undersigned applies for a supply of water at No.tP ~LfJ~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 $_
Owner
Address
Sketch of Service Here
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J/,
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~II
,ill-/1;).
~.~"~~,
Connection made in ~__Street.
Remarks:
Work completed _19