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T,..,x1 nctQn KJrJ a r.s Q N 7("a J.Location I,
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Kind of Pipe ~1.e 11258 SiR ~"Sise Of MaIn r II;
),-,.,•iI*N_Service Bervloe to curb -to be charged Location MAr .2 'l 186&when conM cted.
Da-re Material Amount Total Date Amount i
7/50 Labor 25 80 /LA/.,{'f A".?..-~d 32:"1
lO'l!:o,v",rhead 2 58 28 :'\14 ./
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TOWN OF LEXINGTON-DEPT.OF PUBLIC.WORKS
SEWER DIVISION
DATE .,..••.•.••..•..,•..•.•.He.a .........._......+-
The undersigned applies for the construction of a partieu la r 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 lime established by the Board of Selectmen.
Am't of estimate $ .
Arn't Paid $.
.._•••••.•••"Owner
.
Sket<:h of Service Here ~
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Connt!ction made in... . . . • • . . . . . . . . . . . . . . . . . . ....Street.
Remarks:
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Work completed . • • • • • • • • • • • • •.•19.•
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