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0 <br />f� <br />� <br />LI <br />SUL'MIT P;'VID�NC� TIIAT �QUIPM�N'I' <br />CON[PLI�S WITI-I TI-I� STANDARDS OL' <br />TIIC UND�R\VRIT�RS� LSBORAT012Y, <br />INSPECTION Or SIGN R�QUIRi.D <br />B�1 OR� ER�CTION. <br />CALL 259-8745 FOR INSPL;CTION. <br />APPLICATION I'OR <br />Date �� ✓ b ��7`' <br />�L � i�/Z ,���' �� •/��,� LE� <br />The un3ersigned owner hereby agrees to hold and save harm2ess the CiCy <br />of �v:rett from any and all claimc for damages t1iaL niay arise becausc of <br />installation of Che improvement hereto applied for, and further a�rees to <br />remove same upon notice firom the City and to replace all puUlic property <br />damaged thereby. <br />s��n�a <br />VALUE: CG� � <br />CIRCUITS: <br />r ��c� ��� <br />_ _ t <br />� <br />I� `� x (L� �E7��s_ <br />/ /l /i �/ / � — -' I <br />Own e r <br />Contractor <br />