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f, i . <br />APPLICATIO;d for (/.�! ,-, , i,_ <br />Date � / 0 " <br />i <br />� � ' N <br />` � �% <br />, � _. *� <br />� c,� l /'�, / .; ' — <br />�r.-f. �� _ Q .-_� t r� /t ur�: . i�• _ . <br />r <br />ihe �dersigned a�er hereby agrees to hold and eave harmless the City <br />of E,berett from any and all claiurs for damages that nay arise because of ln� <br />stailatiun of the improvement hereto applied £or� d further agrees to <br />remove sazae vpon notice from the City and ta rep ce all public property dam� <br />aged thereby. � <br />� <br />��� <br />� ��� , �,�� <br />� 6 ' �� <br />i '4��,(� <br />� .��� <br />!�"'-: ���c - �Y o�'��Y J i 9^63 <br />� .... . Yi r f �Y•'.x:::i V�TYi'Y'I� <br />....« .....................,-.....- fifty�;� T'� <br />.r...��........ n_...r......... . <br />Signed <br />/ <br />/'f-D � � <br />— _____`i_ <br />� \ ' ,. <br />.'` \ . .�;� �,�r'�`'y' <br />��+' `` �.\ .A I <br />�'' ��1 �� o os <br />__%��--t �'t � -- <br />` v, <br />C 1" ���•�\\���- -- -.},(, . <br />� <br />iV:;� ('t�m,i'��fn�„k. : .�_�r" �/�sl-.:.,l: �U (_i.�,.�.; <br />Un.�afi, ,{ f � ����I PC: {l��erufr'.f�on �� <br />1! �`r *f,fi'� - .��'�c..rc <br />�� iK �;� �..T,T.�._/5.��,,,,�j; f ���. <br />C�,�—�� � , <br />/ � <br />-- ---,1o:tt.�•aat�.u• <br />