HomeMy WebLinkAboutDUNHAM STName Service No.
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Location
Kind of Pipe
Repair-Renewal-New Service
Size Size of Main
Location
Date Material Amount Total Date Amount
.
.
labor
H.8.M.IBSOl
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't Paid $".,.
.'Owner
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed 19..
Name
Address
b j ,,/
Location
Service No.
Kind of Pipe Sise Sise of Main
Repair-Renewal-New Service Location
Date Material Amount Total Date Amount
.
~bor
H.B.M.IB501
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't Paid $.
.Owner
Sketch of Service Here
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Connection made in.. . . . . . . . . . . . . . . . . . . . . . . . . . . ...Street.
Remarks:
Work completed..,19..
Name
Kind of Pipe Size
Location
Service No.
Size of Main
Repair-Renewal-New Service Location
Date Material Amount Total Date Amount
.
.
.
Labor
H.B.M.18501
TOWN OF LEXI NGTON-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't Paid $ , " ,
............Owner
Sketch of Service Here
I I I I I I I I I III I I I I I I I I I I I
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Connection made In Street.
Remarks:
Work completed 19..