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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
WATER DIVISI~"'//,l
¥VJ!If,;:;,-t/,y/()f';'l;'tT.
The undersigned applies for a supply of water at No.~6#m ~£.,St.and hereby agr"ees to
comply with the rules and regulations as now,or at any future time,established by the Board of Selectmen.
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Am't.of Estimate $~-:::::
.,.----"--Am't.Paid $G~"
Builder _
Owner
Address
Sketch of Service Here......
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Connection made in Street.
Remarks:
Work completed L PI.¥;19