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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
sEWER DIYISION
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NO.
The undersigned applies for the construction of a particnlar sewer connecting No._
Street and hereby agrees to comply with the Rnl""and Regulations governing the construction and use of Particular
Sewers,as now or at any future time established by the Board of Selectmen.
Arn't;.of Estimate $_
Arn't.Paid $_
_Owner
Sketch of Service Here •
Work completed _Conneetion made in Street.
Remarks:
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