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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
SEWER DIYlalON
•
DATE:NO.'--__'---""
The undersigiled applies for the construction of a particular sewer connecting No.1 Upland ROE
Street and hereby agreea to comply with the Rules and Regulations governing the construction and use of PartienI3J'
Sewers,as now or at any future time established by the Board ofSelectmen.
r
Am't.of Estimate $_
Am't.Paid $_
Sketch of Serviee Here
,kJ;,fp Own~
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Work completed 19 •,_f".';~~-~
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Conneeti~nmade in Street.
Remarks:
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