HomeMy WebLinkAboutFOLLEN RD 197Name Pa.nc"o}rJL Juthe Service No.141
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Kind of Pipe Size Size of Main
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Date f'v'1,aterial Amount Total Date Amount
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Labor
'lP-7919 .
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
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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 a .....d use of Particular
Sewers.as now or at any future time established by the Board of Selectmen.
Am't of estimate $.
Am't Paid $ " " .
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Sketch of Service Here
_••.........Owner
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Connection made in Street.
Remarks:
Work completed .•19..