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Date Materia]Amount Total Date Amount
Pt-'7...f3L Labor 95 '76 b'-3/~?/b.Do~Ii--.!2 "'j~CJo
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1 6-Tran 81 te 90°'lhow 5 40
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4 HI's.Town.Shovel ~.50 2E .00
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H.B.M.18501
TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISIO,N
DATE,.....,...,.,.........••.NO,.
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 constrLJction 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 $ , .
..'".,.,...".,.",..".,"..'"",Owner
Sketch .of Service Here
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Remarks:
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