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Date Maferial Amount Total Date Amount
tl/9/fi5 T"29151 2--"'_/".;;:--/1 ,,f,//-:>.._"I .£h1
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1 6"e1.bow 1 88 ,
5 rs.1.1.ttlef'ield ~hovelO .50 :>;"fiO 1
nD'111 ,r,
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Da ch.1=10 X 3 10 Inn
112 iO?
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Labor
HP-969-04------------L-_____ _ _...........__~_'-----.~._.--
~---!-
•
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
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 governing the construction and use of Particular
Sewers,as now or at any future time established by fhe Board of Selectmen.
Am't of estimate $......•...
Am't Paid $.......•••..••••
. . . . . . . . . . . . . . . . . . . . . . . .Owner
Sketch of Service Here
Connection made in ......•.••.....•......••..••...Street.
Remarks:
Work completed.. . . ..•......•...'9•.