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<br />• SUIIMIT EVIDLNCE TllAT .EQUZPFII:NT
<br />•,.0 ', ` e0;9PLIES WI;H THI? STA1dI�I;IiDS OI`
<br />S,,,.,_. A17 APPROVT3D 1'ESTIf7G L�1R012ATORY.
<br />IiISPrC'PIOt� OP SIGId REQUIRFiD
<br />'�' BF;I'ORE ERIiCTIOid. .
<br />, CALL 259-8795 FOR INSYLCTION.
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<br />Applicatioti Date
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<br />:: nDDI2ES5 C vC-'2r r'r l. � l� /�GS/� 2 fo o�g /3!?O/9l7c�f,�j'
<br />`' The undersigned ownen c�reby aqrcos to ho].d and
<br />� City of Evcrcit from any and all clains for damages�t-hat1imaylarise,�e
<br />because'cf installation of the improvement hereto apPlied for,.,and
<br />furthcr agrees L-o remove s�me upon notice fr.om L-hc City and to re-
<br />"placc all public propert=}� daeiaged ther.eby..,
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<br />• Signed —�iJj�"'�,yf�, .� � . %a�t-�-� , �- -
<br />Owncr
<br />', Contractor <�C/?j1 �I AlL=�O/✓ S-2-G�, /rJ "� S �Nn�✓,
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