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Na_T.eJ M nd _Mocoocb1e Senice No.1osl
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T.....,.,.1 In._tnD.Mass.Location .Ii JIll:I w COT"•
Ki....of Pipe Size SUre of Main
~i W*¥--H-Service COM.10-15-51 Loeatioll
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25 120 It,l:'-~..I"/
Date
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Material
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Amount
25120
Total Date
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Amount
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P;;4'_£;"....weI'nib..I!I!.342 HI 14'7 u~b.3
io:1.nt compound 3124
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SO 173
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Labor
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I TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
,
DATE .......•..............••NO..,..•....
The undersi gned a pplies for the construction of a partieular sewer connecting No........•• _ _ _ _ • . . . , . . . . . . • •
Street and hereby agrees to comply with the Rules and Regulations gO"erning the construction a nd use of Particular
Sewers.as now or at any fu ture time established by the Board of Selectmen.
Am',of estimate $.
Am',Paid $.
•__.....,.Owner
Sketch of Sen-ice Here
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Connection made in Street.
Remarks:
Work ccmpleted . .••19,•