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•TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
S~WER DIYISION
~TE NO _
The undersigned applies for the oonstruction of a particular sewer connecting No.//Y/.OJ»iI!#~v&<
Street and hereby agrees to comply with the Rules and Regulations governing the oonstruction anduVOf1>arUcular
Sewers,as now or at any future time established by the Board o!Selectmen.
Am't.of Estimate $_
Skekh of Service Here J"
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Am't.Paid $_
_Owner •
Connection made in m !>22~7 Street.
Remarks:
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Work completed 19
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