HomeMy WebLinkAboutTUFTS RD 16-1
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Date Material Amount Total Date AmOunt i
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .......•.•.••••.••••••••NO ..
The u ndersi gned applies for the cOnstruction of a particular sewer connecting No.......•. . •.......•••.•.••
Street a nd hereby agrees 10 comply with the Rules and RegulatIons governing the eonstruetion a nd use of Partieular
Sewers,as now or at any fu lure ti me established by the Boa rd of Selectmen.
Am't of estimate $.........•
Am't Paid $...............•
..ONner
Sketch of Service Here I ~
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Connection made in... . . . . . . . . . . . . . . . . . ••. . •. . . . .Street.
Remarks:
Work completed ...• • ...........19 ..
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