HomeMy WebLinkAboutUTICA ST 19--,:.
Me-S.....lce No.
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location
Kind of Pipe $1M 6 //SUe of Main·go /'I
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Rtn!JtxAtIt&&td N_51me.l!fCKee 1#4601 LocHion
Date Material Amount Total Date Amount
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In/1O/86 42'6 H PVC
.3'4 H PVC
4"JC 6"'Fernco
Wge 8"x 6".
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TOWN OF LEX1NGTDN-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE ••..•••.••..•.•••••••••••NO..•.•••••••
The undersigned applies for the constructioo 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 ti me establ1shed by the Boa rd of Selectmen.
Am't of estimate $ .
Am't Paid $..
.Owner
Sketch of Se,vice Here "
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Connection made in.. . . . . . . . . . . . . . . . . . . . . . . .... . . .Street.
Remarks:
Work completed 19..