HomeMy WebLinkAboutFAIRBANKS RD 39Name Service No...
Address 6'9 ~-'--......,
')/17 /')3 'P".pvHJ to be connected to Town sewer Manny Location LOTfI.31~OL..........,
Kind of Pipe Size Size of Main
Repair-Renewal-New Service Location-
Date Material Amount Total Date Amount
,
(./~/~c./;;"W61
Labor I)~-JI A.'
.-v ~.
HP-6411
TOWN OF LEXINGTON-DEPT.OF PUBLlCWQRKS
SEWER DIVISION
DATE .............•....••••••NO...••••.•.
fhe 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..