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. <br />SIGN P�RI�7IT nPPLIC11TI0N <br />: UBIQIT LVIDLNC� TIfAT .EnUIPD1�NT <br />COt4PLIL•'S i4ITH T19L S'PAtdDARDS Or <br />Ai7 T�PPROV�D T�STING LnIIORATORY. <br />II�Sl'rCTION OP SIGN REQUIR�D <br />$F,PORL L•'RECTION. <br />CALL 259-II795 POR SNSP�CTION. <br />Applicatiori Date <br />ADDR�SS <br />�>.� <br />�E'�.�-� <br />���� <br />/a�/ 5!�7� <br />UT �--Z��%C <br />� <br />The undersigned ormer hereby agrees to hold and save harmless the <br />City of Pverett irom any and all clair�s for damages that may arise <br />because of installation of tlte improvement hereto applied for, an3 <br />further agrees to remove same upon notice from the City and to re- <br />place all public property damage3 thereby. <br />VALUE : �Dl%O ,D O_- <br />CIRCUITS: <br />.. . , r��: <br />I�LECTRICI�L : <br />TOTAL PEES: <br />� y . u r_. <br />( .C9G <br />R��G <br />/1 ��/' ��, _ ll��(s�Z(o <br />I �e� �c e �',�"— <br />� , �-'�n' r � �U/�1j�C�:tl. ' <br />� ,C�fOt� I..0 <br />( 6 - �(- 7<P. L � �� �c H' �i��1'�,i s P��"� �. <br />�, ,�_ - � . �1�' � , <br />r`L. <br />Signed /t%tE>ei' �i/c t Fi�t...-�e-,- Owner <br />/i / , <br />Contr.acL•or �j6n�.—��%=�it� C,c.s1S_-- �i>��—�rvUd <br />License No. LS"G Z <br />�: <br />n <br />