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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
SEWER DIVISION
DATE INO.
The undersigned applies for the construction of a particular sewer connecting No._
Street and hereby agrees to comply with the Rules and Regulatious governing the construction and use of Particul.~::::11
Sewers,as now or at any future time established by the Board of Seleetmen.
Arn't.of Estimate $_
Arn't.Paid $_
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Sketch of Service Here .
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Conneetion m3de in Street.
Remarks:
Work completed _1~
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TOWN OF LEXINGTON
8XWER DEPr.
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APPLICATION NO.J~:l.9:3f:L .T!l.ll1,tllI'YJ,4 •..............19 38
M~]~ell .._~_.•.~Cassedy.Inc.133 Aus tinS-tr'e·et'-···················.
..qlilllibI'!«:l.g;.ll.....!l!_8:.s_~_·._._._m_.._.._m_.._..9"'RJUr'l'
DEPOSIT for estimated cost of particular
sewer connecting premises at.nelLP...Qffi.c....
.._.._.m_~::=.1\'it~.c=~n sewer in..J!l.!!.J!J•.L.An"',.~m"l 2001 00
Account to be adjusted and any balance due there-
for to be paid when particular sewer is completed.
RECEIVED PAYMENT
",m.o'of iliio £·:·'::,~:.fE::2:1.:;:~,z:mH j
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