HomeMy WebLinkAboutBLUEBERRY LN 19Name
Service installea by develope~
Service No.
619 Blueberry LaneAddress
Location
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Kind of Pipe Size Size of Main
lt8pIjI!K~xNew Service Location
Date Material Amount Total Date Amount
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Labor
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWE'R 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
Sketch of Service Here
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Connection made in .................•............Street.Work completed .......•.......•19..
Remarks: