HomeMy WebLinkAboutCARLEY RD 7t Name Guo1;aFl8o BroU1'JP8 WJ5S/tK.IN Ser".c:e No.
l___Address 7_:::o.rley'Roi
!r-i -±L!.Ie2cx:~i_'"n'___-'_'t~o"_nC..'-J,____'I:::.!I""J._'"3~s~.L_o_c_3_t_io_n_-----!.7--.e:J'--2"--'.."__-::..J_'LT_R.:.:"~():.c~L--1.=-_
Ii Kind of Pipe Size Size of .-.....ain
I Repair~Renewal-New Service G(lllL d-lJ'S_-JIR PE.12~ITHO.~9l4-IH2/....EX OIL Locatio ...
-....1_.1 _
Amount
r.l ~~_i.-..
T;;tI''''''''1Date
~
u·1..l._~U 'IUlJ -'-'CloOO r
I II I OWTJ_'-'
~II 1-\.1 I iSf-\ihajlmers J.hI'c--:rJ _05
-+-II ~I";1l:H.1.P€i J.jn
~4 S9
Material I Amount.Date
t:;2Isc;II JnintCom,:hund
1(1 126 q 1.D3h O"b.,.,hpl"rl
l,JJ IC:Q IL.h6 1 __Jsl'::iewer Pioe ~.26
~IfY;17 1.99'7 I'It>'-tP ·';'PVC
Total
ton"101'1,"1 ~~bor llo;<Lr_~lc -;ot~f 2Jb~[~
I I IIO/~Overhead 1 ~.c1LJ ~d ~
lS'-6"Sewer r'1lpe :0'.26 ~90
---.,
Joint Compound I 9b 1\:~p,"""",1r,.,,..,.,1 hnllH"f-n
iIiIiI'lIr:1..20 --;Jt&nu.,
,,";c'·'rclt.NCO
~''J<,,,':~Ie.N~
HP-791D
I
-'-OWN OF LEXI NGTON-DEPT.Oi PUBLIC WORKS
SEWER DIVISION
DATE.... . . . . . . . •__.NO .
The undersigned COl pplies for the construction of a particular sewer connecting No...
Street and hereby ag r~es to comply with the Rules and Regulations governing the construction and use of Particular
Sevvers,as now or at-COl ny future time established by the Board of Selectmen.
Am't of estimate $ _ __
Am't Paid $...,..__
........................."Owner
Sketch of Service Here 7
I , I I I I I r.i I I I ~7 I I I J.....~I I I'I I I I I I 1-1
I I I I I I I v.L L..I 1 I 1 I-.L~1 I I v;."Io·lc.,;·I I I I I I I I
I I I I I I I I I I L j,_J 11 I I I I '"J-J../I I I I I I LL
I , I I I I I I I I I I I I)l_~~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 ~j..,,1cl.r')k-~do I I I I ~.I I I I I I I I I
I , I I I I I I I I I I M 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 I I I I I ~b"t~tlBoW I I ~~t I I I I I I I I I I I
I I I I I~1¥M 1-...1 I I J-...I I I·I r I I I I I I I I I 1 I I I
I I I I I I I I I I I T I ~I ~II I I I I I I I I I I I I I I
I I I I I I 1..-I~"·"et(e..11 ~!J.....rl ~·IfEi£Et I , I I 1 I 1 I I I
1 \fA-~~fyl I I I i I I A~J..-.t~iH~dtAv I I I ~~II1'1 1 I I I I I J'!'I \ I I 1 I I I I I I~I
PNH (!j
Connection made i r1l .<-~w:.:'(.J?~AO ,Street.Work completed . . . . . . . . . . . . . ...19..
Remarks: