HomeMy WebLinkAboutDIANA LN 19Name Lloyd "T.Baylis Service No.22
Address 19 D1 ana Lane
Location
Kind of_P_i~p-"e _
Repair-Renewal-New Service
Size of Main
Location
Date Material Amount Total Date Amount
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE ............••••••••••••
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--NO.._.....t._..'L_•.__'!__~_eo•__"•••
The undersigned appl ies 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't Paid $.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Owner
Sketch of Service Here
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Connection made in Street.
Remarks:.
Work completed .,. • . . . • . . . . . ...19 ..