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Kind of Pipe Si_Size of Main
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Com.ariiatit Location
Da~e Material Amount Total Date Amount
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9170
5 137
g 170
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6 69
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Tru.ek~ng 2 hrB•••75
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TOWN"OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISiON '"...;c...".
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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 goveming the construction a~cI use of Particular
Sewers.as now or at any future time established by the Board of Selectmen.
Am'!of estimate $"...•."...
Am't Paid $.••,.., • ".•, . " .
•••..•" """"Ovvner
5ketch of Service Here
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Connection made in ..,"..,..: . "...."..,..." . ,....Street.
Remarks:
Work completed " " •.'._ • •••" " " • " "19••
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