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Semce .No.124 j
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K "nd of Pipe Senice
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COM.IO-15-51
SiR 01 Main
Locati_
Date -Material Amount Total Date Amount
o /'.2/1fn I~&.."""
10~
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1
35191
Qverhead
-g-'sewer olloe @ .342
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35191 II ,,?-//-J--/
3160 11-:...;.........-..,;1--/
11163
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SiWiR DIVISION
DATE .............•.......•..NO .
The undersigned applies for the construction of apartIeul ar sewer connecting No.....•.,.• • _ _ _ • . . . . . . . . • • • •
Street and hereby agrees to comply with the Rules and Regulations governing the construction an.d use of Particular
Sewers,as now or at any future t irne estabIished by the Board of Selectmen.
Am't of estimate $....,....,
Am't Paid $.,.
................~~.........-___o...rner
Sketch of Service Here
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Connection made in ..,..,.." , ,Street.
.Remarks:
Work completed ••_ • _}9••
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