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SIGN PERt,1TT APPLIC7ITION <br />SUAMIT EVIDE�]CP TIIRT EQUZPAfENT <br />CG:9PLIES P7IT)1 :llE STAIJDAI2DS OP <br />N7 11PPROVL•'D TESTIIdG LI\IIOI2117'ORY. <br />�%G.J/.OG S/C- �,. <br />/��j1/7✓ '. <br />� ��% <br />INSPECTION OF SIGN RGQUIItED , <br />REFOI2E L•'RF.CTZOtI. <br />,. CALL 259-8745 POR INSP�CTION. ' <br />�J �f : <br />. /�'����7/'�/���.3/ ���v1�lJEi� �+PPlication Date /I GG'�•.r=�,/. %f � <br />�r /L;9d�e%r/ •;�'�c!� C�«�:.<« !-��I ; <br />�--a---� �- --- , ` , � {�=:�(-�.>�7'1_� ��.. ��i� <br />ADAItESS --i -�Y-=t, ��-�rl�_L�_1i�'_�';�G� <br />The undersigned owner hereUy agrees to hold and save harmless the <br />City of L•'verett from any and all clair�s for damages that may arise <br />because of installat-ior. of the imgre;•.;^ert hereto applied for, and <br />fnrther agrees to removc samc upon notice from the City and to re- <br />place all�public propert•y dar��ged thereby. _ ; <br />. . . � . • : � ' VALUE: � ( �(-i ��� � - - J. <br />. . _ - -� � <br />. . __ , . . � <br />5/(�iU LJL'r7.Zlfliv •: . .: ' . CIRCUITSI �� //1E�2',_{� -/ � <br />--�-�-„ ,�f/u <br />� ` . . r_. . ..' , . . FEE: ` ='- ,c�.� _ _ �t j•3 ��_. <br />:.. . V . f <br />• � ' • . . • ., . . ELEC:'RICAL: v <br />� . TOTAL • FEF.S : �"'. �� � . � <br />t!"d . <br />. �..._- - . . . _._..._.;, _. _ ._ .�-..�j <br />. . �•eL'r%'�„� <br />• L � <br />. � � , <br />� <br />�j'+ —=�;� �{-X� IVL�r' P��CJEC TI.Li: <br />. ; `,�J• � L <br />, <br />, . <br />- .�� <br />' �� . . <br />. . �. <br />,.�. �.'..� • <br />Signed <br />� : • �ix�� <br />�. <br />. . L-1-- <br />, <br />L ,y,, s.�_� �,��� . <br />EntSTi.J� , . <br />. : . �(?`�7 7 <br />%,4�;�',,i� 3' ��;;.,�s ��i','�ijeE % . <br />Contractor ' 'EL <br />Li.cen:,e No. <br />C'. <br />. '. Y <br />. ; <br />. •i's�',I�l��i�lu,��<—�l� ;t� i <br />, , . � � � . ' �. <br />� . �'� � <br />� ��` ,ti 'ii <br />._. <br />Owner � �^ <br />_ :;t ��'" . <br />'� --�� <br />j i <br />