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. SIC17 PLit}lIT APPLIChTZOti <br />SIJCNIT LVIDf:;�CG T1fAT EQUIP�lEiT <br />CO;�'LICS uITil TIIC STAtIDA^DS OF <br />AN APPROVED TESTII:G 1.ACORATORY <br />ItiSPECTI0;7 OF SIGp REQUIRED <br />DEFORE GREGTIOIJ. <br />Ct�LL 259-$745 FOR It7SPECTZON. <br />ADDRESS <br />pPF'LICATI0:7 DhTE ���� �j ���i� <br />0 <br />Thc undcrsi�ned owner•hereby ag:ecs to hold and save ha:mless the <br />City of Evecete from any and all clains for darages that r�ay arise <br />because of installation of the improvement ficreto applied for, and <br />further agrces to remove same upon notice�fror� the City [o and �o re- <br />11 blic "o erty d:.maged thereby. <br />placc a pu p. p . � <br />' � VALITE: � ��� '"� <br />. �d ;��r�G <br />5�U <br />CIRCUITS: <br />�v/ <br />FEE: -� <br />`�/ <br />ELECTRIGIL: -� <br />. T,�_ <br />TOTAL PEES: <br />� 1�" pr�MErcr�,. <br />� r <br />►��'ax�f . <br />. :. • �. ( 2oN <br />,� '�i�►%��% . <br />l3Dc7� �o <br />W6�i�- w �w <br />G.%LA� +�/ . <br />. r Z, � �r�}� CA�S <br />. � ,�v MA�x- ��YS <br />. , . �� ,?�{'- ��. _ � � <br />• . o ��: _ _ ,; • � - - <br />. � � . � � � �; ;��� <br />r l S�r "� 191r3 y <br />� „ <br />SIGNED 'iiGGVI..' �� 0'dNER C�TY pl 1.1'-n�TT <br />coxrancror, � rrlc=?T' .��yiJ �O, ���i�i�`���`sP�ct�.:� , <br />__� � -, <br />LICENSE N0. _ <br />. . <br />. -f <br />