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It'jnd of Pipe $inof Maill
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Date Material Amount Total Date ..Amount I
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217 t I ,8 •13 138 3~73 r:Yj1Ac.?I'-It.{,Z/J.J j II/?I
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1t sewer Plne @.2 ~40 '
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TOWN OF LEXU>/GTON-DEPT.OF PUBLIC WORKS
~-'-'-',"'SEWER DIVISION
DATE .••:•••••.••••••••••••••
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NO ,
I
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The undersigned al?P lies for the construction of aparticula r sewer eonnecting No......••........•••••••.•.
Street and hereby ag rees to comply with the RuIes and Regulations gaverning the construction and use of ParUcular
Sewers.as now or at any future time established by the Board of Selectmen.
Am't of estimate $','•
Am't Paid $, .
. . . •• ••. . •. . . . •. • •. • . . . . . . . • •• •• •..Owner
Sketch of Senoice H
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Connection made in ,•••.•••••....Street.Work completed .,........•,....19.•
Remarks:
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