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Kind·of Pipe SiH 6."Size of Main f"
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Malerial Amount
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Date T<:>tal Date Amount
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I4A'-6"sewer DiD @ .34~1f '7:'>/~1;;>£
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5 hrs.town shov 1 (?:5.(0 2£00
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1919--
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .NO .
The undersigned applies for the construction 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 ex at any lutur..time established by the Board of Selectm<>n.
Am't of estimate $ .
Am't Paid $,.
.·..·..·••••.••.."Owner
Sketch of S......ice Here
II \IIII U II 111/1'1 II i 1111111 i /!II I
I1111 II 1±±:1 I /[1'1 I i III,III III II I II I I
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I/!-11'j=-U-\-ITn'Ti'l Iii '-'JIJTIIII 1--1
I I ,1 LJ I I I I I I r-i \1 I -I 1 n I LL t_Ll L Ll .fI I I I UJTTl-rTn-I-(T ~Tn 1 1 I ILTTJTTT1-'I I I I II J L \ I J i-1T-1I-/-r-I-I,-rTI-1 TfTI T1T'IT
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Connection made in , . . . . . . ...Street.
Remarks,
.Work completed ..• • • • • • • • • • • •••19..
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