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HomeMy WebLinkAboutVINE ST 50Address ---T --~----------------"'IIIIt Service No.2TJf , Date Kind of Pipe ~~!t!r:":'"""::Rell.-ewal-NewService Material Amount Size Total Date Size of Main Location Amount Labor "''.~.__•t" ,. :I ___.J I DATE--------=1I TOWN or=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 19 -I~....~~1"\,J I IJ !'III " /V"""'h ""~""\."'"'/"/Vl '""'\..f"\"nV1 l/1 ~/'Ii v II Lr- ti ..~~ "M ~1-'\-t-" """IlII e in Street.Work completed-,.L..., Connection mad Remarks: