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Senoiu No.125
Addrea 'Ii / /TU F TIS R Q.
i I TIf-P U 7?O.g!Le.aIfe.La T IF 349
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"':ind of Pipe
).M,."XR+S4i'd New Service Location Q."h""\l -1 -057 ,
Date Material AmOWlt Total Date Amcxmt
.\
8-12-5~.~52 f\:3 ??~<':?L?"'~~j;'/'/P<?lr.?'
1nct:n.'R !'i I:!R !'iR .n at-/-ff ~~//k 17.ft'"
51'6 1f TrarlBite m.oe @.70 35 70 //..-<7;;7,.
",,..}.o "'yo..n ..i ......l<1 ,,,.9:19:4
1 9:9:J.0 ,..i+-..'Ill1 ,,,.9:.24
9:h ....-~..•I"""0;0 1:0;,00
1 hr.Truckio.ll:@3.(0 3 00
~h...~....'1'...."1 ,..~.nc ......no
2 hI's.Trurold n a @r''5 1 .SO
llRl'7Q
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Labor .
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HP-6411 L _____-~--....,!..
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .NO ..
The undersigned applies for the construction of aparticu Iar sewer connecting No......••••••..••
Street and hereby agrees to oomply with the Ru les and Regulations governing the construction and use of Particula r
Sewers.as now or at any future time established by the Boarei of Selectmen.
Am't of estimate $ .
Am't Paid $...............•
..Owner
Sketch of Service Here /I...
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Connection made in.. . . . •. . . . . . •. . . . . . . •• . •. . . . . .Street.
Remarks:
Work completed .....• .... ......19••
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