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<br /> Date �',k.Y_._, Q ! �Q—
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<br /> APPLICATIOId £or � � "a r�� ���-A-t - ��.._._..,_..��,."a.�r �.%
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<br /> Tne undersigned owner herebt agrees to hold and save harmless the City of
<br /> fiberett from any and all claims f.or damages that may ar°se becavse of installation
<br /> of the i�provement hereto applied f'or� and £urther agraes to remove same upon
<br /> notice from the City and to replace all public propeTty damaged thereby.
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<br /> Signed ' .��Y . ` � �;C�. -;1� - '' ';Jc ,'��hOwner
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<br /> �J� , �7 '' L t .^' Contractor
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