HomeMy WebLinkAboutBOW ST 59Amount
Service No.
Location
Size of Main
•
.Location
Size
Material
Lex!ton Mass
Name
__7 ......New Service
Kind of Pipe
Address
Date
Labor
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 const.ruction and use of Particular
SeW'ers,as now or at"any future time established by the Board of Selectmen.-
Am't of estimate $.. "
TOWN OF·LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE ...........•............NO.......•.•
Am't Paid $...•••_••......
............................•.•.."OvJner
Sketch of Service Here
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Connection made in ..............................Street.Work completed ••.• . . . . . . . . . ...19.•
Remarks: