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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE .NO........••
The unders igned a ppl ies for the construction of aparticula r sewer connecting No.•.•.....• _ _ _ _ • • . • • • . . • . • • •
Street and hereby agrees to comply with the Rules and Regulations governing the construction and ....se of Particular
Sewers.as now or at any future time established by the Board of Selectmen.
Am't of estimate $ .
Am't Paid $.•
,_ ___ _ . _..•"O\Nner
Sketch of SeR'iee Here
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Connection made j n ...............................Street.Work completed •••_ •___• _ • • • •••19••
Remarks:
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