HomeMy WebLinkAboutBERWICK RD 10f~N_am_e_~~u.4.l....-..J,t.--..:I..lo<-..a..JI..:.W..s_e_~__i_c_e__N_o_"_L :i:Qi on v,5e ars
{A_d_d_r_e_ss--=l::....:O:::....·-:0::::.'·.=.e.:::..r...:..:·,N:....:i=-c=-l:.::C_R_o:.....,~_··,_i _
l ..LT""'"e>:;....Xl~·'_n~G·,..l.t~ot...;n"'-_.$_,~Iv:.cL.L:::..:·"":::,:'s~.~L_o_ca_t_io_n____=l_'~_._P.:..,-'_';_l"_·"'_'l__,.;_l_(_R_c_'.~_j_'_
~=============================================l K_in_d_o_f_P....:,ip.,...e S_is_e .S_is_e_o_f_M__a_i_n _
f R~~w~New Service Location~~~~~~~~~~~~~~~~~~c~O~w~.~l~3~-::1~6~-~LL~.~8~~~~;;;;:;;::;;;;;:;:;;:.;~;;::;~;;::;;:::;;::;~;:::;;;;;~;:::;;;;;;:::;;;;;;:::;;;;;;:::;;;;;~;:::;;;;;~~~~;;;;;;;:;;;;;;;:;;;;;;;:~~=
Date Material Amount Total Date Amount
50 !
1 r:;0
3 60
•:':-07.0010 50
17 00
38 93
19 83 7
T'ruckin.z
Joint Compound
Littlefield uhove
r------+--pLC>L_=--~~~~=--=__=~~8c::...>..:2::.::::6+-_--t!-__~+-=------Il--_--+_-+___----------_+----t_-
Labor
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 $_.
.Q\.vner
Sketch of Service Here
I I I I I I 1 I 1 I i I 1
I I 1 I I I I I I I I I I
I I I I I I I ! I I I I I
I I I I I I I I I I I [I I
I I I I I ,,I I I I I I I
I I I I \I I 1 [[1 I 1 I ,
I I I I I 1 I I I
) )
,I I I I I
I 1 I I
[1
I
1 !I I I I ,,I I I I Ii
I I I I I I I I I I I \I I I I 1 I I I I
1 I I 1 I I ! I I I I !I ! I I I \I I I I I I 1 I I I___1 _1 I I I I I I I I I I I I I I I I I i I I !I I I I I
I I -r -r l-f-1 I 1 11 j f -t t-+I f If l 11 1-+-l.-~-ll
Connection made in . . . . . . . . . . . . . . . . . . . . . . . . . . . ...Street.Work completed • . . . . . . . . . . . . ...19..
Remarks: