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. <br />0 <br />SI(�L•1tMIT APPLICATIOti <br />SU4MIT LVIDC1iCE TIIAT GQIJIPMF.NT <br />CO"fPLICS WITII TIIE S1'ANDARUS OF <br />AN APPROVED TESTIFG 1.A40RATORY <br />Y�,Y <br />IHSPF.GTI01� OF SIGN REQUIRED • . <br />AEFORE GRECTION. ' ' <br />CALL 259-87k5 FOR INSPBCTION. <br />APPL7CATION DATE � � <br />ADARESS �;.,�1 � ' � '� �.�J � � ~�� <br />The undcrsi�ned owner•hereby agrees to hold and eave harmleas the <br />CLty of E�•erett Crom any nnd all cleims for dama�ea that mny arise <br />because of inr.tnllation of the improvement hcreto applied for, and <br />further agrees to remove same upon notice Crom t.he C'Lty to and to re- <br />place ell puUlic preperty damaged thereby. <br />VALUB: �Z�f�r]•- <br />C�cuzzs: 3 <br />FEE: � S� �v <br />ELECTRICAL: <br />�� <br />TOTAL FEES: 20'�� <br />/�-T3E�L'7'~�� o +�VP�-�i►�ir7l�'r _ ��� r <br />i 3 �. `�1� . 3llf..Ls �It 1z pc-A-.-� H C..� A. <br />� I�+�.lr�� ►.� <br />�� � « � G�� <br />��-�"�� �� ��l��l�� <br />SICNED � 1'� �'"�-�r.�-- _�� <br />/ <br />CONTRACfO(1 " -- -�-r — �l-i?K+�-]E�L—Zfs'iS'�) . <br />Licr��se tao. �• � ��� — <br />0 <br />