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Service No..,2..,()fa.
Kind of Pipe
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Date I Material
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Location
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DATE----------eTOWNOFLEXINGTON-BOARD OF PUBLIC WORKS
WATER DIVISION
l
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 $_
Owner
Address
--:J.t.-Lt-lU~v
94:#.(13,1 1 oL.St-
Builder _
Sketch of Service Here
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