Laserfiche WebLink
� � � <br />- ' • . Slt,fl PGIUIIT APPLICi�TION <br />SUCM7.T IiVIDE1�CE T1iAT EQU7Pt4ENT <br />CO?tPLTP•.S WITtI 'Ctli: STANDARDS Or <br />AN APPRO�'ED TESTItr'G LABURl:'LORY <br />It�SPF.CTION OF SIGN REQUIRID <br />BEPOR� rREC'iION. <br />CALL 759-57<<5 POR INSPGC.'T:4N. <br />/ <br />APPLICATIOti DATG —) vuE l`i-. Iq� <br />ADDRESS 7°'�'Z � Ev �E*r�*oEp�l ��A-y " <br />The undersir,ned owner•hereby a�recs to hald and savc harmless the <br />C�ty of rverett from any and all claims for damages that may arisc <br />because of insCallation of thc improvemcnl• hcreto applied tor, and • <br />further agrees to remove same upon notice fron the City to nnd to re- <br />place all public property damaged thereby. . <br />' VALiJE: `�//00 �' <br />CIRCUITS: �� ) � <br />q, OC� <br />FEE: � <br />S .'O O <br />EI.ECTRIGSL: <br />TOTAl. FGES: I.�" �� ' <br />� Les� � r.+,'—� r��P <br />C eaoc.rv�/ • <br />• i i � <br />,��c`T. �t ) 7 X ll �b F- <br />a hf Gxl STI �.LC. ST'TLU�TcJ 2�. <br />�.C��'a-T � 1�•, <br />SIGNED �f � -�� s � � �rv .�•a2ri OWNF.R � , <br />CONTRACPOi. T'U'B�•„�zT�3>lSPLAXS —S�A-r7t—E — L�."S�—SG�—Z-BS'`Y � <br />LicensL ho. _z�o 3 , <br />. --��/��t�/-Gr/I" `�.\ r�'z;,-� . <br />