HomeMy WebLinkAboutSIMONDS RD 87Name
•Address
cg _2~_Lm d N r:L s '7?0 jl c:L
.Kind of Pipe
Repair-Renewal-New Service
Service No.
Location
S•/"I~S'f lUI'(7 /IIser.:::>.Ise 0 main lJ
Location
Date Material Amount Total Date Amount
12-9-li71,,1 ~"Sew eo""~~t!
I (,I.Y ::B..,.aIVc"h
Labor
l:...l'n £it1 ..
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 time established by the Board of Selectmen.
Am't of estimate $ .
Am't Paid $...............•.~./j~.~...:...Owner
The layout and location of this
Sketch 0t..Service Here r 7sewerserviceconnectionisin
accordance with J.J'J "'r;-'~T~I;'I I 161Yl-4+~I I I I I I I I I I I I I Iandinstructiono:s ul lULl:'I~.~r't I I I 1 I I I I 1 I f8'l71 I I I I I I IofPublicWorks.L v,~~.o 1 I I I I I I I I I 1 I I 1 I I I I I I I I I ITownofLexingtvL..1.1 I I 1 I I I I I I I I I I I I I I I I I I Iappreciatethatr~··-I......v I I I I 1 I I I I I I I I I I I I I Ichangesinal:!J~~I '"-:P.I..I:'IO I I I I 1 I 1\3 I I I I I I I I I I I I I I I I Iundergroundwitw..,......0 I I 1 I I I\J I I I I I I I I I I I I 1 I I I IcleanoutsIand::L IJ.1"_v •.~I I 1 I I 1 I I~I I I 1 I 1 I 1 1 I I I 1 I I I I11,..,..assume a reSpVLLo:I u......II.1.13 1 :lm I I I I I I I I I I I I I 1 I I I I 1 I I I IanycoststhatLllCrJI~o 1.1.v!"'4 v '~I I I I I I I I I 1 I I I I I I I Iduetostoppageo:s~I I 1 I I I I I I I I I I I I I I I I I I .I
1 1 1 I 1 I I I I I I I I I I I 1 I I I I I I I I
Sf;on#'t "h d,y
Connection made in Street.
Remarks:
Pta'.
Work completed .......•........19..