HomeMy WebLinkAboutCHASE AVE 15Name
Address IS Chase Avenue
Loc:ation
Servic:e No.
Kind of Pipe--'--------
Repai~»~~UYn(e
Size of Main
Loc:ation
Date
Labor
Material Amount Total Date
NON CHARGE
Amount
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
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 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 $..........
Am·tPaid$...............•
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...Owner
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed . . . . . . . . . . . . . ...19..