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HP-6411
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION '.,
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DATE •..•••••.•••.•••.•••••••NO .
The undersigned appl ies for the construction of apartleular sewer connecting No........•.•.•••••.••••••••
Street and hereby agr~s to comply with the Ru les and Regu latiens governing the construetion and use of Particular
Sewers.as now or at any futura time established by the Board of Sel ectmen.
Arn't of estimate $.....•....
Arn't Paid $.
. . . . . . . . . . . •. . . . . . . . . . . . • • . . . . . . •..Owner
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Connection made in ...................•.....,. . . .Street-
Remarks:
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