HomeMy WebLinkAboutVINE ST 17 19Kind of Pipe
Location
Size
Service No..2 l'.2?.
Size of Main
Location
Date Mat~rial Amount Total Date Amount
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.
Am't.of Estimate $ _
Am't.Paid $_
Builder _
Owner
Address
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed _19