HomeMy WebLinkAboutBLUEBERRY LN 21---
Service installed by developer
Name -Service No.
Address #21 Blueberry Lane
Location
..
Kind of Pipe Sin Size of Main
.,...x .......New Service Location
Date Material Amount Total Date Amount
I
~
Labor
,
HP-6411
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
!I 1 \I I I I I I I I I I L I_
I I I I I I I I I I I I I I I I
I LI I I \I I 1 I LLI I I I I
I I I I I I I I I I I I I I I I I
I I 1 I I 1 I I I I I 1 I I I I \
I I 1 I I I I I I ,I I I I I I I
I I I I I 1 I 1 I I Ll I I \I 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 1 I
I -I I I \ 1 I I I I I I I I 1 I I I I I I I I
I 1 I 1 I I I I I I I I 1 I I I 1 I I I II 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 I
Connection made in ...................•.....•....Street.Work completed ................19.•
Remarks: