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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
~$EWER DIVISION
DATE ~.\..s-(rj3~NO._
The undersigned applies for the construction of a particular sewer connecting No.\ \ -l3 ~'5\-
Street and hereby agrees to comply with the Rules and Regulations governing the construction a~arbcular
Sewers,as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $_
Am't.Paid $_
Sketch of Service Here ·e
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,
,
Connection made in Street.
Remarks:
Work completed ~_19