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......neorg e $11])1 van Semce Ne.28
.-.'I'&&psnl Bevet'e aoadd>e ~ul A'e.lfere 1?",..J Lee.....
~K....e .Sin ~N $h<e of Main i 1/
:I'-*WA-M._New Service LocatiOJl C"'-....£'-/-,flY;
Date Material Amount Total Date Amount
_'1_1'>0 ILabor '74 40 f/.-/-£c ID",__.-r-dCX'co
_1fi_f\O ..1:'\_]Ii R'7 Ifi5 i<.j'-£a ~E -II /.;7 I~-,.
10%O.R.a '16 96 31 /9-;/..P'7
RO'F;"'1'.....'"~..'I '1-...,,1 ""i @).'1R 41'\IRO
4 St~oks Dynamite ~.26 J Ifl4
4 Bla"''''~~(;a""@).Po8 1 112 ,
::'I h ....~In"JAv -~.($fI.Ii(10 1<;,.,
2 .bra.Truekln"@.175 1 50
1 ............n ...@ .nn "'-In,.,,h,..T,..,..,Ian Loade r @3.00 :3 00 .
1 h .....'l'ruekina @:3.bo ~Inn
12 x :;Patch 12 00
Labor I 1R'1 12'7
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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 ti me established by the Board of Selectmen.
Am't of estimate $....•.•...
Am'!Paid $.............•..
. . .... . . . . . . . . . . . . . . .... . • • • . .....Owner
Sketch of Sen-ice Here~q
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Connection made .jn.. . . . . . . . . . . . . . . . . . . _. . . . . . . ...Street.
Remal'b:
Work completed.... • • • • . . . . . . ..•19..