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Kind of Pipe
Address
Name
Repair-Renewal-New Service Location
Date Material Amount
Repair Leak W.O.1126 .Total Date Amount
-Labor
1It Style .38
1tf x 4"Nipple
.3/4"Curb
yda.Gravel
tons 1tf Stone
3/5/79
2
2
1
6
4
4 hr.Trucking
~hrs.1'o}l'J;l Shovel l
Labor ,\'--,
~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
Address
Builder _
Sketch of Service Here..--"~.4...~..;:\~J ~1 •J-,I'-,..",
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K I-NI..It...II ~In!.....
,
Connection made in Street.
Remarks:
Work completed _19