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SIGN PERMTT F�PPLICT�TTON <br />SUEt4IT EVIDENCi: THAT EnUIPMENT <br />COSSPLIIiS WITH TIl� STANDARDS OF <br />AN APPi;OV�D T�STINv I,�1gpIt7�T012Y. <br />INSPECTION OF SIGN RE;QUIRL;D <br />$EFOR� ]iRE^TION. <br />CTu,L 259-g7q5 POR INSPECTION. <br />Application Date <br />_5 - /C - 7�" <br />ADDRESS � � I,� � . ��L��� � <br />�,� D.��._ <br />She undersigned owner hereby agrees to hold and save harmless tlie <br />Ci.ty of Lverett £rom any and all clair�s for damages that may arise <br />because of installation oL- the improvement hereto applied for, and <br />further ayrees to remove same upon notir.e from the City and to re- <br />place all public property damaged thereby. <br />' �'ALUE: � ���(�) � <br />CIRCUITSr l <br />.._ .. ' ... FEE: �-' . --- <br />' ELECTRICAL: i�� S <br />!i'7 L�- C�✓L/ ^ <br />.� �/ <br />`; . �� �,� <br />� <br />C-*�-'(�( � G' <br />�-� �L� <br />!��� � �� (,� l� l C FS <br />ii� _� � ' � '' � <br />S1CJIiC.'CZ :� <br />Cor.tr.actor <br />Li:er.se No, <br />TOTAL�FEES: <br />�����vLG CCNJ /1-il -Gv t <br />��- ; � , -?�� -�� <br />_, � , <br />� ' �� 1_- ;. .. <br />�:�: .�: ,. _ <br />t .._• ,� <br />9 <br />- j' / • r i ,,. ._'_ Owner <br />=�--�' O-`�-�----� <br />7= :•'c: , � ;.J� _. ���%�-- ,( i' <br />v <br />; <br />; <br />�; <br />