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Se,rice No.J
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'.ca·,1?T.,.i_7&.::»,.I·Ve.-,-Location 3 Patriots Drin ],_.---::J
Siz'e of Main J I,-----I'Kind of Pipe Si.-e C;;U
t""-fiXVPgspr New Senice [1_..s-h,p hr-/--•
Date Material Amount Total Date Amount ,
3/15/5]Labor 16 '1'1 16 on .~-.~-1----/-J~~I.r___;,(./~""""w..
loll:O"\\f,erhead 1 63 ~-3.,~1I IA?-/."'if''(.,?"IHI
;0--6-Sewer PiPE 8 .3h1.17 20 ~..LIf-'>¢
Jo:1n.t C<DIDPound -'l,00 I
~-R......T.of ....,."18'd Shove •7.]5 00
2 Hr••Truckinp:1 .sO
7u.66 I
I
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-.i
Labor .I
(Service was in to cur)-o char~e)
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
£lA"FE .NO.'"•.•.••
The undersigned applies ~or the constructien o~a particular sewer connecting No..........•••........•.....
Street and hereby agrees to compIy with the Ru Ies and ReguIa tions governing the construction a nd use of Particular
Sewers,as now or at any future time established by the Board o~Selectmen.
Am',of estimate $ .
Am',Paid $....,..•.,••, , ,
.............................., . ,•.Owner
Sketch of Se.....ice Here
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Connection made in ,,Street.
Remarks:o.,.,~;I't.1 .s.-r,,;Ce.~-2$~4 r t:.Work completed :,19,..,
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