HomeMy WebLinkAboutFOLLEN RD 151Name •Service No.
Address IIJ5"I Fa Ilen Pd.
Location
Kind of Pipe Size._-----------=Size of Main
Repair-Renewal-New Service Location
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Date Material Amount Total Date Amount
10-1'7-7Z.
90I 0'~/Y'arJs;Te
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/6"-22.;;~o Elbow
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Labor
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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 $.
.•.•••..............••.••...•......Owner
Sketch of Service Here
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Remarks:0.,.i ~IN ij J .s Q,.v;c -eo e,.3--$"7
Work completed .... . . . . . . . . . ..•19..