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HomeMy WebLinkAboutWALTHAM ST 676Amount Servic.e No·M ~Ir fb.7 .. Location Size of Main DateTotal Size Amount ----~----~--------.1 Material Name Date fir.s.L abQr,..maki connectl.on •..55 Labor +---~-~~-----+---tl-----+_.--I--------_..__.----j----..-.+"""---.. AddressAm't.Paid $_ - - --.--','--.-....'-,.~~_'"--,-"_','---,f.~)_.~ DATE -7~).,.."·,".'>.3 ~.,.,.- TOWN OF LEXING I\,,;-BOARD OF PUBLIC WORKS WATER DIVISION The undersigned applies for a supply of water at No./"fr ::/t'.4:St.ar,td hereby agrees to comply with the rules and regulations as now,or at any future time,established by the Board of Selectmen. Owner ()vvvu.~T...,...~.~.i,<:':~..t"I.<:....,','."V '..~·f,.,.;,'.~..·..../~.,...J.,I•...".•,.~..."..;_,)(J~..-~.Z:-~.}<'".-','•,-•\.""'tz,,'2./~&(:"'i2·-~--"""~'--J-+--J.-..=",::......-:;.;;:;.:=-...::..::....;:-'--'=--~ ~<//<1/(:: Am't.of Estimate $._ Builder _ 19 Sketch of Service Here 16 •••,~.. .~ll.~, , .~ t I;) .-,.I;»'-~'J 1/ 'flIT ~.....~,.Ie /1...2'j}·to ~, ')~V~\Work completedein~~Street. /( .'Sf!'; ~\i'~ Connection mad Remarks: