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\TOWN OF LEXINGTON -BOARD OF PUBLIC WORKS,
SEWER DIVISION
DATE ~4"£..4>_NO'"7_~_-
The undersigned applies for the construetion of a ,particular .sewer connecting No.?~0"7.or Q'--:::;
Street and hereby agrees to comply with the Rules and Regulations governing the construetion and use of PartieuIar
Sewers,as now or at any future time established by the Board of Selectmen.
Am't.of Estimate $_
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----Am't.Paid $~9'_'_
Sketeh of Service Here
~\£~Owner
Connection made in Street.
Remarks:
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Work completed 19
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