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Na_Pet.er ToumaYan Serwlce No.60
Address #-19 TU FT~ltD.
,Sise of M.in r ,-SiIe <G "Kind of Pipe
19Tu.pUs 7(.'a J.location IOT"33?
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bHii tllsis.'"New Serwic,e iMo at ?tie 7'7 Location /J./-..:tT 7:'¢',
Date Material Amount Total Date Amount.,
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1M n.H.6 8~7),191 Yr1./--<:~7,:1 ,}75 !
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?H .....'1'....",Iri n"<Ii ,100 6 !oo .
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HP-6411 ....~
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
".~.SEWER DIVISION
DATE~..........••••••••••+...NO .
The undersigned appl ies for Ihe conslruction of a particular sewer connecting No..............•••••••••.•.
Street and hereby agrees to comply with the Rules and Regulalions goveming Ihe construction and use of Particular
Sewers,as now or at any future Ii me established by the Board of Selectmen.
Am't of estimate $ .
Am't Paid $.
••. .... . . . . •. . •. . . . . . •• • •••. . . . ••.•Ov.mer
Sketch of Service Here I '-
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~Connection made in :. . . . . . . . . . . . . . • . . . . . .Street.
Remarks:
Work completed ...., • . . . . •• . .••19.•
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