HomeMy WebLinkAboutWARD ST 37iJ1i7.2R22
AmountDate_Total
St.,
A.ffiount
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,Kind ofPiJ)~
-----:----~-----I-NewService
R~pau:~Renewa ._
MaterialDate
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Labor
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DATE -11TOWNOFLEXINGTON-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..-....-..-l
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Connection made in Street.
Remarks:
Work completed _19
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