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Date Material Amount.Total Date Amount
"a/51 T.abor·1F 16 1.6 1Fi /A·,:-'br-/,/J _.."in/'/;;;-n //-d
n«ov';'rhead 1.62 //-i'_cC f-/flY::''l~Z./.<",I.~.P
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2 18
5 hr••Lltt1.ef1el(above].7.pO 42 00
2 hra.'trucklnd '15 150
ha'tch.1.na 1.5 ...::-.15 00
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .NO :.
1-
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Th!1 und!1rsignl!d applies for the construction of a particular S!!Wer connecting No..........••••..••.•,•••••<-
Street and hereby agrees to ,-..-;-';'""'h thl1 Rcr!es and R!1gulations governing the const,...ICtllon and use of Particular
$ewers,as nowar at any future time established by th!1 Board of Selectmen,
Arn't of estimate $ .
Am't Paid $..;.
....................."....•~...."Owner
Sketch of Service Here
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Connecti<Jn madE!in ~~--:~Stre!1t,
Remarks:,'-
Work completed ••_ _ _ • •••• . • • •..19 _.
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