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12 Stedman RoadLoeation-
Address 12 Stedman Road
Date Material Amount Total Date Amount
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Labor
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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.
Amtt of Estimate $..Owner .
Am't Paid $.Address .
Builder ;..
Work completed 19
Sketch of ier~Here
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Connection made in :...street.
Remarks: