HomeMy WebLinkAboutSIMONDS RD 36Address 3 ~5'\monel:;
Kind of Pipe
Repair-..Itenew~J~New Service
Size
S~l"Viee No•.2¥£7-
.-rF:2/8
Size of Main
Location
Date Material
Labor
Amount Total Date Amount
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 $_
Owner C...~,)~
Address ,36 ~~~~,--vl-=·_
Builder _
19
Sketch of Service Here--...oiIt
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Remarks: