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� <br />SIGII YEP,[]IT APPLICATION <br />SUE14I'P PVIDENCE T1fAT ]:QOZPAIL•'NT <br />CO.,PT IPS {VI'Pll TI31: S7'ANDARUS Ol.' <br />Ali APPROVL'D TliS'1'iNG LAIIOR7ITORY. <br />I1ISPECTION OI' SIGId REOUIRED <br />EEFORP EREC'1'ION. <br />CALL 259-p745 I'Oli I2dSP1:C1'IOI7. <br />j � /��- %.< <br />D %�1.� <br />��=. ': <br />nl�pl:icriti.on D<Zte �[�ri �' /� i�/ %( <br />AUDRL;SS �_7�B ���cif' <br />The undersig.�ed owner hereUy agrees to hold and save harmle:;s thc <br />City of Lverett from any and all. clains for damages that may arise <br />because of installation of the improvement h.:reto applied for, and <br />further agrees to remove same upon notice f-rom the City anci to re- <br />place all public pr.operty daciaqed thereby. <br />v�,i,vs: �`300`.� �,��^ <br />CIRCUITS: I ( � �L; <br />rar: <br />rr rc.��iicnL: <br />To��r+r, r•�,rs: <br />��� <br />Signecl �Cci:,o�� C7/"c ��r.-��.��_�� �,c . --- Owncr. <br />Coniracior �i�� -�%-�i�e �Inf < 1�� �D .�ox 9��k.�,F.�f lij«, •'�>g'D,�6 <br />% Lic se/ p. �SSi�`��.-- . � R�,nc: ,.�.0 . �_, <br />:� �,�,,/�%� �,� �i � <br />Liti'LC�.�f���_. �'�=�"%`r' ` i(��-.�.� y•:.-,..__ �c<->,�.—.,����.-1 ��. <br />