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LEXINGTON-BOARD OF.PUBLIC
SEWER DIYISION
TOWN OF
NO
The undersigned applieB for the construction of a particular sewer connecting No._
Street and hereby agrees to comply with the RWeB and Regulations governing the construction and use of Particular
Sewers,as now or at any future time established by the Board of Seleetmen.
Am't.of Estimate $,_
AIn't.Paid $_
_~~---__Owner
Sketch of Service Here •
.---_.-~~-_:~~-----
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Conneetion made in Street.Work completed 19
41·..•·Remarks:I
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