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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
SEWER DIVISION i
DATE{Jr..21.12/1 ~~~(1;f#tf.
The un:S;gned applies for the construction of a partkular sewer connecting No.~"'1f :zf!il.
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Particu r
Sewers,as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $....:f1£jrc)
Am't.Paid $£',-_!l/!o;"n..-"d.~-!frr--9.j:..
~~,..,-~-;//h £!jI//.R (A¢_aA
~.St ~tch of Service Here a ~1/.......
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Connection made in",-,Street.
Remarks:
Work completed _19