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locatiOft '
KiM of Pipe Size Size of Main'-i
~XIUJOO.4lClO'N_Service SERVICE INTO CURB Beyond centre of'streett...eatioft .
Date Material Amount,Total Date Amount ,
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fA /t:::"'l ."h.~..../,?12 Ih",!!~n~_""'__"Ii 21 h6 3~I
h '"I .-It ._~....~P'~-~cc 8 80 NON CHARGE ~
I"u ""---"l...-..,..1 Iiil.l (00 20 00 7/0/c?'L'"In....?,(),?,
1~6 -._'c._~7<:;6'_<;""'r'"site Pine @.<:;<:;"lO
7-/1--o~N d~..$<!.y";ce ...,,,..AI<.">f~~....n 1':h ~,,_1 {,;J,().()()?f ,,()
24 ';;"...se.we~"P,~e 7<;
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Labor
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
flit oJ-f.,.il'"
DATE ...•.........•.......~NO.'"..•.•.
The undersigned ~pplies for the construction of a particular sewer connecting No...,.'.....•..•........"••••
Street and hereby agrees 10 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.
Arn't of estimate $ , ,
Am't Paid $ , ,..
.,..•••••..•.....Owner
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Sketch of Service Here ~-l 4 '
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Connection made in ,.,_Streel.
Remarks:
Work completed ..••-.. • • . • . . . ..•19.•
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