HomeMy WebLinkAboutREED ST 109Name
Address IOe,REED 0 £,7:
Location
Service No.
Kind of Pipe
Repair-Renewal-New Service
Sise Size of Wlain 8"I
LOcation
Date Material Amount Total Date Amount
F
Labor .
H.B.M.18501
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 Re'gulations governing the construction and use of Particular
Sewers,as now or at any future time established by the Board of Selectmen.
Am't of estimate $ .
Am't Paid $.
.,'Owner
Sketch of Service Here
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Connection made in.. . . . . . . . . . . . . . . . . .... . . .... . . .Street.
Remarks:
Work completed 19..