HomeMy WebLinkAboutSUMMIT RD 9------_._-_.~.--_.-
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Address .Jjot O~Suminlt Road·__
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Kind of Pipe Size f1>"_.'_'.__Size of Main [_11 _
~U'=New..sm:M:~__...__._._.............Location
Date Material Amount Total Date Amount
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DATE~/_O_-_(.:-.-)__,.r_·..£2-L'1__
TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIVISION
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 $Iv ,t,..1)
Am't.Paid $_
.(......,f4 ~~_..::~::._._Owner
Sketch of Service Here ~.e
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Connection made in Street.
Remarks:C.x /c5t pl"t:lp~~I hi ~
,""IIC ~6(of 16e>'01IIl..6-4.$
Work completed _19