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TOWN OF LEXINGTON-DEPT.OF PUBLIC WORKS
SEWER DIVISION
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d\,DATE .NO .
The unclersigned a pplies for the construction of aparticu lar sewer connecting No...
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Particular
$e\IVers,as now or at any future time established by the Board of Selectmen.
Arn't of estimate $.
Arn't Paid $....._...•.....
......................•......,..•"Owner
Sketch of Service Here
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