HomeMy WebLinkAboutMIDDLE ST 36.....W11i i-..:In lLSn1"villn 93
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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
DATE•.••••••••..••.••.•••••••NO .
The undersigned applies for the conslruction of a parlicular sewer connecting No..... . . . . . . . . . . . . . . . . . . . . . . .
Street and hereby agrees to comply with the Rul es and Reg ulations governing the consI ruclion and use of Partieula r
Sewers,as now or aI any future ti me estabIished by the Board of Sel ectmen.
Am't of estimate $ .
'Am't Paid $...•..••.••.••••
,"..................................Owner
Sketch of Service Here
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Connection made in Street.
Remarks:
Work completed.....•...........'9..