HomeMy WebLinkAboutFAIRLAWN LN 16t Co Inc.r.os.. ,Name DeVr1 eso
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Service No.
Location
Kind of Pipe Size Size of Main
Repair-Renewal-New Service Tnsb'lllerl bv nAve]onel"'Location
Date Material Amount Total Date Amount
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----10 i 1 6'4"pvc·.~--
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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 S~vice Hered.tladll~
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Connection made in.. . . . . ...":;1"~""""""""Street.
Remarks:~'~cr
Work completed 19..