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<br /> ,... _. .........,.._... ......�itv Cl� Date 9 — // — lo /
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<br /> APPLICATION for ��=(�r��-v• �. fii c17i�C.G�, � (V-'�.-c,j-�-ti GL�C-2�v:- t-i� : C (' t
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<br /> Th dersi� owner hereby agrees to hold and save har ess the City of
<br /> L`verett from any and all claims for damages that may arise Uecause of installation
<br /> of the i:nprovement hereto applied for, and fluther agrees to remove same upon
<br /> notice from the Cit;� and to replace all public property damaged thereby.
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<br /> Signed \/ . CGe ' ""�"�` Owner '
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<br /> ,.., (,� � ' � � % � ��,� ��f ) _Contractor
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<br /> � "'�� �� �� , ��/!�� [�/ �ocatioryApproved._.�L//!��<s�.-.?�ii
<br /> m�C• ��C'4e ,[(; ��,�a-xy��.'lG��u/.%���/y� �nspected..............»..........f:«.;�:...:�
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