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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS
SEWER DIYISION
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The undersigned applies for the construction of-a particular sewer connecting No._
Street and hereby agrees to comply with the Rules and Regulations governing the oonstmction and use of Particular
Sewers.as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $,_
Am't.Paid $_
_,Ownllr
Sketch of Servire Here
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COOIIIeetion made iII Street.
Remarks:
Work completed _19 •.__•~~;~~.~~.::;~:.='___'_-~._c:....__'__-_-_~•._:..~_-.:.~_~_....:.::.••_~,~'"'._._~~<A.,:".~.~~._..~_._...._--'~__"";.-;:~-~_~-•.L...:z-""~:.l.Jsc"'-..~.~-i