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TOWN OF LEXINGTON-BOARD OF PUBLIC
SEWER DIVISION
DATE NO.-:-
The undersigned applies for the construction of a particular sewer connecj;ing No..:f""M.J.."a eli-
Street and hereby agrees to comply with the Rules and Regulations governing the construction and use of Partieular
•19Workcompleted_Connection made in Street.
Remarks:
F~-
Sewers,as now or at any future time established by the Board of Selectmen.---
Am't.of Estimate $
~c Am't.Paid $- -~--
Owner
Sketch of Service Here L~"-•
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