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:TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
S,EWER DlYISION
NO:--
use of Partieolar'
DATE _
The undersigned applies for the construetion of a partienlar sewe~conneeting No..........
Street and hereby agrees to comply with the Rules and Regulations govermng the construeUon and
Sewers,as now or at any future time established lJy the :Board of Selectmen.
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Am't.of Estimate $_
Am't.Paid $_
_Owner
Sketch of Service Here .-
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Work completed .19ConnectionmadeinStreet.2·t Reo:uu-ks:...F.,,'a,-..'¥i~.;i",,;;.:ili:1.;<-;;';'i";'''';'''";~~';''''"';;':'";'i.i~~J~';4.d::;,/...,;'ic.""t.,i.,,~id~~c:ai.""~._..,;;.'>""';'";~~."';.L;iili",._<>':~-4.;.;!;;L.Ti""j