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Address
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Kind of Pipe
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Size Size of Main
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1,
Amount
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Date
15005
TotalAmount
•50
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Trucking
MaterialDate
COST
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1 S &W 3 00
75
TOWN OF LEXINGTON-BOARD OF
WATER DIVISION
DATE--- - - ------------~
PUBLIC WORKS -~
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 iuture time,established by the Board of Selectmen.
Am't.of Estimate $_Owner
Am't.Paid $_Address
19Workcompleted_ConnectIOn made m Street.
Remarks:
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Builder
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