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HomeMy WebLinkAboutWHEELER RD 19::~;ft$,i;:4449_-"~,,=.-~.=:-::::---~-'------'--;--.~,._.'.~:_~T~-.,-_~.~--~-,-~-----,--_oc=-~•...••_.A.-':;;z,........~_~ Name A4c1_s DeVr:l.••CO. Location S.rwice No.~_.&-.-...•• Kind of Pipe Sin 6"Sin of Main f"I ••FiII'''·k New Service Location i Date Material Amount Total Date Amount ,n c'l.TV<::!on ..T T.".'"l'lV .~~~i I 88'i - I ,•! i I I I Labor T-, i I ! i HP-969-4 1 •J J -~_..---, TOWN OF LEXINGTON-DEPT_OF PUBLIC WORKS SEWER DIVISION i '.ft DATE...••.•.•_. _. .__••_•NO.__.__.._. _ The undersigned appIies for the construction of a particular sewer connecting No... . . . . . . . . . . . . . . . . _. . . . . __. Street and hereby agrees to comply with the Ru les and Regu lations gove rni ng the construction a nd use of Particular Sewers.as now or at any future time established by the Boa rd of Selectmen. Am't of estimate $....__. _.. Am-t Paid $._. _.._..._. _ ...._......_........__.._.._....__Owner Sketch of Service Here I I I I 1 I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I I , , , ,,I I I I I I I I I I I I I I I I I I I IJ I I I I I I 1 I I I I I I I I I I 1 I I -I 11 r I I I I I I I I I I I I J I I I I I 11I1I111111111111111111111111111 U...,.,.,.1IIIIIIIIlII111ILJ 11111 !I I I I I I I I I I I I I I I I I 1 I I I I I I I I ,,,,,,,,,llllTllllllilllllllllllll , , , I ' ,'I 'rTTTl I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 I I II 1-I I 1-I I I I I I I I I I I I I I I I I I I I ..U-IT-II-I-I-I l, Connection made in ___Street. Remarks: ~----- Work completed..,_..19..