HomeMy WebLinkAboutWALTHAM ST 193IHlld 81 f~J?~
Repair"'"7Renewal-New Service
Size
Service No..,2R/I'-
Location
Date
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Material
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Amount.'-
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Total;·n~Jt-Date Amount
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Labor ,I
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11
DATE----------eTOWNOFLEXINGTON-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--~liIlII IlIIIIl'
II II ,~,..
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~"1ft~.
Wf r-
,
Connection made in ...,--Street.
Remarks:
Work completed _19