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i / <br /> Date � ;-�� ^ ��L� � <br /> APPLICATION for � � / �� � • � � ` <br /> l � ' �� � t% � <br /> _ � , � ;"" _.' �� ! _ � � 't , .1 <br /> . <br /> The undersigned owner hereby agrees to hold and save harmless tf�a City of <br /> �erett from any and all claims for damages that may arise because of installation <br /> of the improvement hereto applied for� and flu�ther agrees to remove same upon <br /> notice £rom the City and to replace all public prop�rty damaged thereby. <br /> ',,�yr—_ <br /> N`�_ � <br /> �,,�,.�,,w.�, uy��q ,�� 7 5 ,�°�° ----- <br /> a .-- <br /> . - <br /> s,�.c��,., `� � '`� ^"'�`'`a�..c�.� ' i <br /> ,� — � <br /> �� _ _ ��.�,�� <br /> (d-- �=c"V 7�"��` <br /> —v� <br /> � <br /> � <br /> � <br /> ��•b„ � '� `g6o <br /> PJ� ... � <br /> .•*atR <br /> .r!'AV'`��� I..... . . G�(r 5 . <br /> ,, . <br /> I� ' � i <br /> � 'i i ----��=� f�� <br /> � (�1� s i <br /> n1 Ch.a,� les / er - <br /> Signed ��. ZfL2K`-v . / =��'" Owner <br /> _ � <br /> /. i <br /> .�' <br /> / l�r`�_.,i i� �F � ,7 G� , ~; t � � -c_ ;.�.� Contractor <br /> l r ,� <br /> c i�.-1„\l.\�\�.. � ,.._ �-� .Xf�,�-.,J <br /> �k� � V. ��� �� ,t��.� �i�rJ <br /> ��,E'_,;�5��>e'i�i y.e��t ('��d:L(Jr�'✓/'l��l� ��; l � � i.nae�M App�oYeA.�.� �.__.. . <br /> � � z��r����_ <br /> I' <br />, <br /> ` � <br />