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DateTotalAmountMaterial
1 n<l:overhead I ,,126 II "7ISL./0.//./9 i t:::f:?£_"/1.7~2'
Date Amount I
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1 IIT"_BreX Shovel I I II 10 100 II 711./S31 Labbr I 301 00
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I'TOWN OF LEXINGTON-DEPT OF PUBLIC WORKS
SEWER.DIVISION
.;.:.~
.DATE ..NO.__...•.••
The undersi gned appl ies for the construction of a particula r sewer oonneetiog No.• • • • • • . • . . . • . . . • • •
Street'and hereby agrees to comply with the Rules and Regulations governing the construetion and use of Partieu Ia r
Sewers.as now or at any future ti me established by the Board of Se Iectmen.
Am't of estimate $,.
Am',Paid $.., ,...,..., , ,,
..., , ,, _ _ • .•...."Owner
Sketch of Senrice Here \J Y 2-
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Connection made in ....... . . . . ..., ... . . . . . . . . . ...Streel.
Remarks:
Work completed .•_ • _ _ • • • • . . . ...19..
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