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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIYISI
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,Th dersigned applies for the construction of a particular sewer connecting No.7d<>-e'-:''''.I:!2vr:'
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Plll'ticular
Sewers,as now or at any future time established by the Board of Selectmen.
F Am't.of Estimate $,_
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Am't.Paid $_-Oz7le~
Sketch of Service Here
Owner
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Connection made in Street.
Remarks:
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Work completed..,.:..::::19
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