HomeMy WebLinkAboutLEDGELAWN AVE 3Location~N.....Serwice Com.11_1),-1,0
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Date Material Amount.Total Date Amount i
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TOWN OF LEXI NGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .•.....••..•••........•.NO.., .
The undersi gned applies for the construction of a parlicul ar sewer connec1ing No.,.'".,........•••,..••..•
Street and hereby agrees to comply with the Rul es and Regu lations governing the ccnstruction and use of Particula r
Sewers.as now or af any future time esIabIished 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..
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