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;r , <br />• SUB`:ti; EVID;:NCT '�FL�T EQUIP:; ��iQT <br />GO\i?LIi'.S :VITIf TH� ST :i.'DARDS bF <br />� T�iL JNDr.R\V1.ITERS' L_iiuCR!?TORY. <br />I\S�ECTIO\ OL' SIGIV R:EQUIF.ED <br />.,i'_FORF' ERI:CTION. � <br />G� LL 259-8 ��5 I'OR INSPECTION,. <br />4P?�LICATION P'OR <br />/9%�7 5' <br />Date �/ ,� `/ �� <br />� � � ,� 2 v N �r �' � 5�., <br />✓"T �J l.v� �s <br />S � ,S �'� .� � <br />Ti7e undersi�ned o�:•ner he:r�b}• arrees to nold and =_ave ha�r:�less the City <br />oi ;vere'tt from any anu all claiiz_s zor ciama��s tha: ^i.'>' arise b�cause of <br />installation of the im,�ro:•�n.7ent here`_o aFp'iied for, ancl furt!.e: a�rees to <br />_e:nove sa::ie vaon r�otir.e i:•�m the Gity anc to reaiace al'i public property <br />d�maged thereby. ' <br />� �-, /i �� �,�� c� il2Gvt <br />� y!/.%Y"�L(/' <br />t/� Q � <br />�1" <br />�L11 � ✓4'G�/1^-`-�"t� ` � � <br />/GGt�!`�o"�. Gv(k iz.�Fi� � _��i�X-�'`'v(. <br />���,�,, ,�.� ,��.,,ti, .��� <br />c�'� �„�- <br />� �� <br />Signed <br />��-�w-��. �-�. <br />���� <br />VALUE: i��0 � '- <br />CIRCUITS: � __ _ <br />�% C9-U <br />� . O�C� <br />a <br />� � . . _ , . , . . , . <br />,� ,�,; <br />_ �,_� ;� _ ^:; t . . .. i <br />� <br />f3 v� G. v. iL. - I�.. C. �1—% 3 0%� ' <br />0 <br />a <br />Owner <br />tractor <br />� <br />� <br />