HomeMy WebLinkAboutBLUEBERRY LN 4Name Service inst~11ed by d$velope~Service No.
i Address #4 Blueberry LaneI
1
I Location
Kind of Pipe Size Siseof Main
~rX"~New Service Location
Date Material Amount Total Date Amount
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TOWN OF LEXINGTON-DEPT.OF PUBLIC \MP~1<$
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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 gover'ning the construction and use df Particular
Sewers,as now or at any future time established by the Board of Selectmen.
Am't of estimate $.
Am't Paid $.
•III Ow'ner
Sketch of Service Here
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Connection made in ..................•....•......Street.Work completed ...........•.•..19•.
Remarks: