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Location ,.II?-;I .2 7
SerYice No.
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Kind of Pipe PVc Sise @/I Sise of Main B //
Repair-Renewal--New Sel'Yice Location
Date Material Amount Total Date Amount
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Iz//A ag 6 '1 PVI'.1'34,'-14'II 33/0""p'V.c.
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I I I I!i I
DATE _
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIVISION
Sketch of Service Here I 0 3
I I I I I I I I
Connection made in ...... . . . . . . . . . . . . . . . . . . . ...Street.Work completed .
Remarks:.
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