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Location
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16 hlt
Labor.
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.-.
DATE -'-....".:.,.;:..;,,"'..:,__
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
WATER DIV.SION
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 .
..
~t -I Ch of Service Here -
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Ii:,I )'!,~'I'II'..••.,.~.,~
....•~"Ie ,""l1lI w~
Connection made in Street.
Remarks:
Work completed 19