HomeMy Public PortalAboutMark Out Request
165 COMMERCE PARK ROAD BREWSTER, MA 02631 PHONE: 508-896-5454 FAX: 508-896-4517
Mark Out Request
Date: ____________________ Account #: __________________ (To be filled in by BWD)
Address: ____________________________________________________________________________________
Property Owner: ______________________________________________________________________________
\
Intersecting Street: ____________________________________________________________________________
Date of Work: ________________________________________________________________________________
Type & Location of Work: _______________________________________________________________________
Mark-Out Location: ____________________________________________________________________________
Mark Out: _____ Water Main _____ Water Service
Dig Safe #: _________________________________________ Date Good: ___________________________
Name of Caller: ____________________________________________________
Company: ________________________________________________________
Phone: ___________________________________________________________
Digging to be done by: ______________________________________________
Brewster Water Department Use Only
Date Marked: ____________________________ Signed: __________________________________
Logged in Mark-Out Book: _______________________________________________________________
Comments: ___________________________________________________________________________
**ON ALL WATER MAIN MARK-OUT’S OBTAIN MEASURMENTS FOR ALL GATES**