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Date Material Amount Total Date Amount
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1 25
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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIVISION
DATE -u!"o.f
The unde sig d applies for the construction of a particular sewer connecting No.I ~~/w ~
"ct Street and hereby agrees to comply with the Rules and Regulations governing the construction find use of Partcliliu'
Sewers,as now or at any future time established by the Board of Selectmen.
61',JY::::t~1-¢;:a:t~w--4,~}.._...t-0
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Am't.of Estimate $~~~Ulv r J1V/#>~u \r
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Sketch of Service Here
Connection made in --,-Street.
Remarks:
Work completed _19