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S1GN I'ERI•SI`P APPliIC11'1'ION <br />. <br />SUE1hI'P PVIDENCP. TIIR'1' FQUIi�1d1iNT � J�-� -�� <br />COI,PL:CL•'S WITII �IIli S'PANDAPDS OF • � � j�� <br />T:ta APJ.'ROVEU TLSTINC LA73UItA7'OP.Y. <br />It7SPLC'PION OP SIGAT 12PQUIRI:D � <br />�/ '�/ % <br />Y.F.FOItE i;P,liC'!'IOI�. . <br />CbLL 259-II%95 I'OR INSPECTION. " <br />' Application Datc /'ii`f"/wFY �S� /' <br />���r1i¢G: '•�6GT2/�° J`'/Pt� �% <br />n�D�ss �:'i20,aE�,v /f�oyv2 C'�2. !• TO, . <br />/ 2 O Z. ��/'�2�Y�LEficJ ---' <br />The imdcrsigned owner hereby agrees to Lo1d and save harmless the <br />City of L'veretL- irorn any and all clai.ms for damages that may arise <br />because of: .i.nstallati.on of the i.mprovement heret:o appli.ed for, and <br />furL•her. ae�rees to r.enove s<vne upon notice irom the. City and i;o rc- <br />place all�public proper�y damaqed thereby. , <br />. _ . . � � VALUE: _ ' (9.S_O oD. . . . . <br />.' � . . . . . . ..� ..., cir<cvi�s: � / <br />_ . ,.�� : , ��.. . 'rr•:,:. �� , oe, - . <br />.. , : .. ' ...�.". ' F.LECTP7CAL: .�� (��'' . <br />. . .. • . : • . Q <br />. �roT�v,.� r�Es : (� - 'S� <br />���.��,��•�.� � . <br />-' . � 1�1 <br />. . . . . � • . . . . . �....I � • . <br />j � ,Z� ���I', ^ 77 ��� ' . , . : <br />� _ . �; � . , . . <br />� � . i i. �/ � � ..�. titt� Po�ri�,c> c� �ei� ,U �. �'o P�Jc�T <br />�� '�,Lc`tl.'_K'N'�c•�..:�ZSy'� �-t�zfEwo• PP�o�� C:I..�r. . <br />�' ' � . - � <br />�'1 sinued .. . ..� .. . .. . ../r �'�' �-GR�c O�,�ner <br />`y <br />��, ' Coni;ractor. . . . . .' . . . . : • ��/�l2�?7 .S%Git/ CO . <br />.. � �� <br />License P�o. ___._ <br />� <br />� • .. , . <br />�_ . . <br />'� <br />; <br />'� <br />