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TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS,
SEWER DIVISION,,DATE •,-NO
The undersigned applies for the construction ~a particular sewer connect~No.J4:L£/44/ZZ cfl/,l1"<:'~
Street and hereby agrees to comply with the Rules and Regulations governing the constructiop:and use of Particular
Sewers,as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $,_'.
Am~.Pmd$__
_~Owner
Sketch of Service Here
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•Work completed 19
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Connection ~in Street.
Remarks:
•••I '"-~--..-.-,-"";%_V~;~~~,'"'-<.~.....'.:;,..«'"_'.iL';..i.'_";";'-&,:,.~";_",-";"",;,:;-~-~""""--~~-,,,:,o:~,,:.-.<ft-··'-f°e;-·.::.;.'""ziz::--~_=-'-~,.'~---·::"-"-i 1.'J;-......._~":::-).t=',-_'-...d'e-~-_~:~~-:~~..:.,~~-~:.:i'\.----::'£~'I