HomeMy WebLinkAboutSMITH AVE 14---~--_._...~~<~~
_0 Name 'Stanley I~Phalen,""t·~Service No.-!S '1'..20
__-.:A=dd=ress _..'~a:-S?QkS A....s.,PrnnilQri~;4!:'
..../9 SIItJLfiv.e.«Loeatiol1~Sml ':h Ave.
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Kind of Pipe Size t:.~I _______~ize of Main i.I~--~-----
Location
Date Material Amount Total Date Amount
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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
~:SEWER DIVISIONDATE~~/[3a NO.,_
The undersigned applies for the construction of a parti~ular sewer connecting No...;:::40~~.
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 $_
Owner
Sketch of Service Here
Connection made in Street.
Remarks:
Work completed _19