HomeMy WebLinkAboutBERTWELL RD 104\
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Name 'Rverett TWombly Service No.JI/4/••T
Address 101}~ertwell Road
Location 104 Bertwell Rpad
Kind of Pipe Size Size of Main
~fi-NewService Location
Date Material Amount Total Date Amount
Nov n 4'7 ',Ahol'"50 26 /7m/.('i.}f}r0VA..vJ~~~I /~J-00
7 "29 90 80 16 ~.31 47 c;]J~P"_.AI'_/Y ~
tlO<Jt Overhead 8 02 .//;b l.s-i
53'-6f1 Sewer P .pe @.2€13 78
Joint Compound 3 12 \
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Labor
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HP-6411
TOWN OF LEXINGTON-DEPT.OF .PUBLIC WORKS
SEWER DIVISION
DATE .............•..;..•.•••NO.., .
The undersigned applies for the construction of a particular sewer connecting No..................•..•...•
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Particular
Sewers.as now or at any future time established by the Board of Selectmen.
Am't of estimate $.
Am't Paid $.
. • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...Owner
"Rei.
Work completed . . . . . . . . . . . . . ...19..
8.;1"-_11
Connection made in Street.
Remarks:
Sketch of Service Here 104-
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