HomeMy WebLinkAboutLILLIAN RD 21_"!""""_a:=_-+.0f'~•
Name
Address
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BI1&L E:roo thlll'.a __Service No.12i::"
21 Lfl11an Road
Location
.Kind of Pipe Size Sio:e of Main
!~III_II.......New Service Location (1...M d -\<-$~
Date Material Amount Total Oafe Amount
7/~h 1r::1 T ...'h~~f.0:>':1 7-h'-,17 YO ""7 7"A/'
lOot Overhead 6:2 n Ar::1-1.//-,J?'JI £/JS;/#'5
I 11~.<=:0
f ".,~<f{d be
I 2 bra.Town shov 1':1 00 !Cl..,.v1...._....1,.,..,
1 h,.'1',."A '"1 ...0'!lll 7r::7r::Owner's P1 ne n .."i T..on -!
0:>"I...."
-
Labor
1)/L2..~/./#..:1.~<F p c v A'....l?':
f I"'?///-#'/-A ....,,'~.
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
D1'\FE .•..••.••.......••.••••.NO .
Tf1e undersign ed applies for the construetion of aparticula r sewer connecting No....•.•.•••••.
Street and f1ereby 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 Sel ectmen,
Arn't of estimate $ ,..
Arn't Paid $.
.•............................•....Owner
Sketch of Service Here
I I I I I I I I I I I I r i I I I I 1 I ;ill I I I I I I 1--1 I
_I_U_I_I_I_I_I_I_I_I_IU_I_I_I_I_I_I_I_I_II_II_I_I_I_U_I_L
I I I I I I I 1 1 1 I I I I I I I ill I I 1 I 1 1 1 1 1 1 I I
I I I I I I I I I I I I I I I I I I I I I I i I I I I I I I I [
I I I I I I I I I I I I I II I !I I I I !1 I I I I I I I TJ
I I I I Iii I 1 1 I I I II!1 I I I I : I I I I I I I I I I
I I I I I I I I I III .I_LLU I I I I I I I II I I I !I I
i I 1 I 1-1-1-1-1-1 -I I I I I I 1 1 I I I I I I I I I I !I I
i I I I I I I I I I I I I I 1 1 1 I 1 I I I I I I-I I I I I I I
I-I I I I I I I I I I I I I I I I I I I [-II I I I I I I I I
I I I I I I I I I 1-1-1 II I I ,I I I I I I I I I I I I I I
Connection made in ,•..•..,Street.
Remarks:
Work completed .....•.. . . . ,•.,.19 ..
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