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Kind of Pipe Sw.Size of Main -\'%
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)al"e Material Amount Total Date Amount 1
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':I.A.-6-Sewer P;foe 411.16 1.~68 //....L.?l
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
ri/DATE .
The undersigned a pplies for the construction of a particui ar sewer connect ing No.• •
Street and hereby agrees to comply with the Ruies and Regulations goveming the construction and
Sewers.as now or at any futu re time established by the Bo a rd of Se lectmen,
Am't of estimate $ .
NO..'.
Lise of Particular
Am',Paid $.
Ovvner
Sltetch of Service Here
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Connection made in . . . . . . . . . . . . . . . . . . . . . . .Street.
Remarks:
Work completed •••_ ___•• • • • • •••1 9 _ •
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