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TOWN OF LEXINGTON-BOARD OF PUBLIC WORKS
/AI ~"C SEWER DIYISION,:::;~;)v=4..'
D/'.TE ~~Iur ;>t ~hU">.~-
The undersigned applies for the oonstruetion of a particular sewer oonnecting No.,l.<-:f~£(171 d:-
Street and hereby agrees tooomply with the Rules and Regulations governing the construeti 8.nd use of Particular
Sewers,as now or at any future time established by the Baard of Selectmen.
Am't.of Estimate $G3'~G:01?-
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AIn't.Paid $_
Sketch of Service Here
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lIIaMJAa/i;pwner
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Connection made in Street.
Remarks:
Work completed 19 :.~._-
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