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e <br />a'IGid 2'El:f•;.l`P ,�Pi�1�1C?1�:�]:OIJ <br />SUL'i:T'i' 1;VTD]'stdCIi TIU�'1' TsQUIPDiLN'1' <br />CO::PLYE i P7I'1'❑ i'IIE S7'11f'.UR1jpS 01.' <br />Att T�PI?RO��lU 'P�S'PIPIG ];A73Ui21�1'ORY, <br />T�:��':s'CTIOiQ OP SIGV RLQUIR];D <br />L'F,FOIZL: PP,EC'I'ION. <br />Chi,L ?Ci9-�{��J F012 T115PLC7'IOI1, <br />� Ap;�].icati_on Date �g <br />, � <br />1�1)�R13SS � Q ��� .��/1� /�/iy . ^ <br />1he iinder.siyned owncr her.�by �igre�� to hold �v�d save harmless the <br />�' �-Y o� L•'verei:t from any and all clair�:; for ciamages that rnay arise <br />1>ecause of insi:��11�1{:1G71 of ihe i.mpr.ovement herei:o app].ied f:or, ai�d <br />further agrces to remove same upon notice f:r.om the. Cit�• and to re- <br />place all�public property daraaged thereby. <br />• ' . • V11LUE: p da • . <br />. - --�-�-'C <br />• . . :. . .. , CZRCUITi: _l <br />. ... r �_ <br />' , . .. .' . ' FE�: . , C�� . <br />f, . <br />. � ..., • : LL�CTP.TCnL: , <br />'POTAL_• F't;ES : <br />� .� <br />r.� /Q �- <br />i `� <br />�`� Sig,�ed ' � <br />` � Contract•or.' <br />�\\ L;.ce�ise Np,, <br />\� <br />.. . �, . .. . .. <br />� - <br />--' <br />-�� , .. . _ , , . <br />..• r � � ' •. . . . 4�' . <br />. .. ' � .. :� I <br />' �C.S` o� � '� <br />�� , <br />: , .. .. . : • ` <br />. � �' ��(�[���C�� <br />[� <br />� � JUN 13 1978 .• <br />' . CIiY.OF EVErTETT. <br />� - �c3nwn D�3, . <br />— /s'�Lirrr /%���,i�/1/ Owr�er . ' <br />-,5 z__ 4�,u p_�t5 G 2. <br />�_ . •,. <br />, �f <br />