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TOWN OF"LEXINGTON -BOARD OF"PUBLIC WDRKS
SEWER DIVISION
Sketch of Service Here
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'nnection made in ..Y'f<:":-'-":'~..F.-':'~....•Street.Work Cflmpleted .#.I..#r.-..PI?:..~~~y..
Remarks::............•.-•............................•.....................•"".."..••...•........•..•"...•..."..•.
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0-_s.-.~_-'~__:0_---:0-_0.--'_~to eurb -to be eharged wheh eonne'oi;ed
Service No.
,Address 19 Wood]"RQ Ro"a
Loc •r ......'n"'to"..,v .....ation A //-/.v--",-~I
Kind of Pipe,)Sin Sbreof Main
New Serrice Location
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Date Material Amount Total Date ,Amount
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i Tm:lTALLED BY CON t'RACTOR :,.",-l::?":/,5".2f"
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I10ItOverhead6627260
10 I 6"Tranlllite @J 70 7 00 !i 16'6"Cast Iron Pip<f@ ,I 96 31-36
10'6'"v.c.,Pipe 4 35 I
1 ~.,1/8 Clay Band 1 24 ,
!2 E!rs.Town Shovel @I 6.50 13 00,I~~r~»:._.:....g e ~;:;~~I 1
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
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DATE . . . _ . ..NO .
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The unde.-signed a ppl ies for the construction of apartic ula r sewer cannecting No..
Street and hereby agrees to comply with the Rul esand Reg ula tions govern1ng the construction and use of Particular
Sewers.as now or a l'any future time established by the Boa rd of Selectmen.
Am't of estimate $.
Am't Paid $,•....
."Owner
Sketch of Se mce Here
,-........!""..Connection made in._Street,.
.Remarks:
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Work completed •.•...,•.."....19 ••