HomeMy WebLinkAboutFLETCHER AVE 6r
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Date
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Name
Address
Kind of Pipe
Repair-Renewal-New Service
Material
Labor
Amount
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Loeation
Size
Total
Service No.
o /7e/che-r ~ve.
Size of Main
Location
Dale
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Amount
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIVISION
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NQ.~_.,....'..__
6 Ek/c,,{er 4ve
DATE _
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 •-f-
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.£~,~,(1....~./~~
I''"'~~~,"7I'"/-.
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Connection made in Street.
Remarks:
Work completed 19 •