HomeMy WebLinkAboutDEE RD 15Name John G.Farnworth Service No.
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Address :L15 Dee Road
~xin~ton.Mass.Location
Kind of Pipe Size Size of Main
1tppa~""M-New Service Location
Date Material Amount Total Date Amount
1
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Trucking
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Lab or
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e
Labor
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
Sewers,as now or at any future time established by the Board of Selectmen.
..... .... ...... .. .........
use of Particula r
Am't of estimate $.
Arn't Paid $.
. .... . . . . . . . . . . . . . . . . .... ."Owner
Sketch of Service Here
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Connection made in .... . . . . . . . . . . . . . . . . . . . . . . . ...Street.
Remarks: