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. SIGN PBRMIT APPLICATIUN /5'� / <br /> SUDI+IIT EVID�NCE TIIAT .EQUIPPIENT ���/I �6 <br /> C019PLIES l9ITF1 T13L•' ST7�NDT�RDS Or <br /> lit7 APPROVED TESTING LAIIORATOI2Y. <br /> • , > fy^;�' 'y"' a.�i',;,. . - . .�� <br /> .[1�SIECTION OP' SIGN REQUII2�D — ' <br /> 13FPOI2E liR�C'fION. ' <br /> ChLL 259-8745 POI2 INSP�CTION. <br /> / . <br /> Applicatiori Date ,rEi /� <br /> �wD�ss ����2 Co[,F�v �v�Rn� <br /> 'Phe undersigned o�aner hereby agrees to hold and save harmless tlie <br /> • City of L•'vereLt from any and all clains for damage: tl�at may arine � r <br /> because of- installation of the improvement hereto applied for, and -_�! I' I <br /> further agrees to remove same upon notice from the City and to re- <br /> place all public property da��aged thereby. . ;,� �I��i <br /> i 'r <br /> . . VRLUE: ,5� � � � � <br /> r ' 4 <br /> CIRCUITS: / � <br /> . � <br /> ... rs�: � CO�' ` <br /> � , <br /> ' . �LTCTRICAL: � • � � � ��r;� <br /> TOTAL PEES: (a .�c� _ <br /> ,'ry°� : <br /> , ' i <br /> � � . ,: A ='�� <br /> . i <br /> � � C . <br /> (`; v{�� ' r� . i . . <br /> `� . ,b(�� , d /� / - �r�.�19�"I� � <br /> �` � �p-Z �� ��- � '. <br /> � � <br /> �� �/ � . <br /> Signed� fA` Owner <br /> ,\} Contractor /L! EK C�'�[a�/ F 1ii �'L4- /,"��,?�� ; <br /> � �.�-�.- <br /> �,� i <br /> Licence No. .�3 � O�- /c�-cQ2 <br /> `\ <br /> �, <br /> l \ - - � <br />