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,~j;;).Jar I Don']4 t1tppi.8 SerYiee No.'zs6 '1;t _.iIf _I
AU,II 33 S Marrett Rd.'J
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Kind of Pipe,Size Size of Main;
<__~N_Service SERVICE INTO CURB Locafion ?2.-.-.2-5>9-e:::'J i,
Material IDate..-Amount.Total Date Amount ,
,0 /<=:"1 La'bor 22 6a .d-yJf'-p.........'~"-'/4 __~&-7
~overhead 24 95
,,,-./'Ad '10 2 27 J#~"".h!J
,C::_c:'1t ""....••"'"'Pi n,ral ,C;C;8 2<;'/£91-7'-\
1 rTO T.;+.+'",f'i",lCl She vel 7 <;'0 ...."---
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I']09!O.R.6 l77 71.1M.,
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS~
SEWER DIVISION
DATE,.NO........,~'"''"'
•
The undersigned applies for the construction of a particular sewer connecI ing No.........•. • • • • • • . . •... . • • •
Street and hereby 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 Selectmen.
Am't of estimafe $ .
Am't Paid $.
.:,...••.•__Owner
Sket<:h of Service Here •?
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11[111111111111111111111 11/11:11
Connection made in,.. . . . . . . . . . . . . . . . . . . ... . . . ...Street.
Remarks:
Work completed " • • • • • • • • . • . ..•19.•
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