HomeMy WebLinkAboutWOODLAND RD 20J.
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TOWN OF LEXINGTON-DEPT."OF PUBLIC WORKS
SEWER DIVISION
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DATE . _ _ _ .__.NO...••..,.•
The undersi gned a pplles for the construction of a parti cu la r sewer connecIing No..,..,.....•...............
Street and hereby agrees to·--:-;-',''.~'!!!1 the Rules and Regulations governing the l:""'!~tntil"ion and use of Particular
Se'ollfers.as novv or at any future time established by the Board of Selectmen.
Am't of estimate $__.
Am't Paid $, .
....•.........."Owner...~..~...~...~.~~
Sketch of Serv;ce Here
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Connection made in ..............................Street.Work completed '"...,.,....,...19"
Remarks:
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.~...~Name
T"¥"--'serv1~e to ~urb ""------.~~---
to be oharged when oonneoted
Service No,
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'"•..Address 20 Woodland Road
location
sUre of MainSiIeKindofPipe!
i ~*'L-...New Service Location
,Date Material Amount Total Date Amount
,.Tll1 v 1 '''1 Flat Rate 30 00
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!10'_6"sewer pi @ .3~~13.42e-
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TOWN OF LEXINGTON-DEPT:'OF PUBLIC WORKS
SEWER DIVISION
DATE _..•..........
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NO ,
The undersi gned a pplies for the construction of a particula r sewer connecting No..
Street and hereby agr-ees to comply with the Rules and Regulations governing the construction and use of Particular
Sewers,as now or a t a ny future lime esI abIished by the Boa rd of Selectmen.
Am't of estimate $._.
Am',Paid $_.
."Owner