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.SIGN P6Rr1IT APPLIGITION <br />SUBMIT EVIDCNCE T}IAT EQUIPMENf <br />CO,fPLIES F1ITH TIIE STANDARDS OF <br />AN APPROVED TESTIfiG I.ABORATOFY <br />INSPECfI0P7 OF SIGN REQUIRED <br />BEFORE EFECTION. <br />CALL 259-5745 FOR IhSPECTZON. <br />ADDRESS � / V <br />0 <br />APPLICATION DATE _� � u,n e� t 9jg <br />• The undersigned owner•Fiereby agrecs to hold and save harmless the <br />City of Evere[t from any and all claims for daroages that may arise' <br />because of installatton of the improvement hereto applied for, and <br />fur[her agrees to remove sxne upon notice from the City to and to re- <br />place all public Property damaged thereby. <br />�� � � t $9�:. <br />. VALUE: <br />I. /Q � � CZRCUITS: � <br />�� <br />FEE: , j C <br />ELECTRICAL; <br />lGrk�u..�r— <br />TOTAL FEES: <br />LN.Ii'T� a0N_ <br />t.+�d e f a �y �, �„ _�,.;�3 <br />� <br />a <br />r <br />3 <br />t <br />SIGETdD �� . ^, K:�ji/%' ��,��-` OWNER <br />• � — . <br />con*rcu�cro� _� f MC.O S���.V c.D. �/L�G �. <br />Licens� ro. � 5 �•/�'�G � OS, L'�2P 3 <br />� <br />�� <br />