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TOWN OF LEXINGT~N-BOARDOF PUBLIC WORKS -,
SEWER DIVISION ~
DATE NOc"'--_
The undersigned applies for the construction of a particular sewer connecting No.£2d£:&u.t?n:
Street and hereby agrees to comply with the Rules and ReguJatil>ns guverning the eonstruetil>n and use of Particular
Sewers,as now or at any fnture time established bl'the Board of Sele~
Am't.I>f Estimate $
Am't.Paid $
Owner
Sketch of Servi~Here 170 1I •I I I·
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Cl>nneetion made in Street.Work eompleted 19.-~~'kc~~_~j~:""',.~~~"~_"_",~~.",,,,,,~.0,".L_,",.,;,~~,,"~~..,~L_"';"'j ,,)i,c,.,"",.,.,.'d·"m kO','#.·t'''''''''';;;i;;,,,''','$'"","%'''~'.J.r€'.....