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LEXINGTON-BOARD OF
SEWER DIYISIO'N
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_TOWN OF
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DAT';"e Under~gne~apPliesfor the OOlliItruclion of a particular sew;;'connecting No.~MiJ:°trt'A
Street and hereby agrees to comply with the Rules and RegulatioIlB governing the coIlBtruclio
Sewers,as now or at any future time established by the Board of Selectmen.
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Am't.of Estimate $_
Am't.Paid $_
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~'~Owner
Sketch of Service Here ••
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Connection made in Street.
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Work completed 19
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