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Kind of Pipe Sin She of Main..,...,••.....New Sen-ice .Location
Date Material Amount Total Date Amount
ll/26/5~La:01'20 1.7 /",-,).&,f.rb JL 1-~.#-'45 00
10 I.2 OC:22 k2 v't-s-J.-7 -P~JA,~Jg£-"J,joverhead
~o1l35
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.:5'.;1 ri j//U 4-52 -6'"SeW81'pipe 22 62 0/1 ,6/
Jo at Compound ~17 t#'49 Sj I
2 brs.Trueking @ ..'5 1 150 ~
1.Q 81
LaIIor
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DATE •.~
~-....,.........,
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
....~~.~.....
--~,
NO.•.•••••••
The undersigned applies for the construction of a particular sewer connecting No.......•.•.......••••••.••
Street and hereby agrees to comply wIth the R",Jes and Regulations governing the construction and use of Particular
Sewers,as now or at any future tjme established by the Board of Selectmen.
Am't of estimate $.....,....
Am't Paid $, .
.,Owner
Sketch of Senice Here
=1[1 I I (((11]1=1 CI ,=,'=:C:IJ~I=U I II'!1]:1:[1:
11111 11111 111II 11111 III III 11111 11_
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o I I Ci I I~[I ell=I U iJ]:j ]]I I I [[[[CC
f I I I I I II J [I J 1 I 1 I I I I I I 1 1 I I I j j I I I I I_
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1I111 f 11II1 I111 '--LUI IIII j 11111111
I I I I I )r I I I I I I J I 1 I , I I I J I I I I I ±±±±I I
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Connection made in .......•...•...........•....••Street.
Remarks:
Work completed .....,..........19••