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. . _ . . .. . ._; .. <br />_" . ��%�:�.�.:_�,�_.;[ ,J �lti�'i��_.:_j;._. . . <br />/N r�,:, � � :�n.; ti� <br />G. <br />RFPt:_C� g`. : , ;��'_� � <br />, . - ., � _. - <br />�-':. ,. _ J --T i �,, �J t- <br />The undersigned owncr hereby agrees ic hold and save harmless the Ci�y of <br />F.verett from any and all cloims for damage: thol mny arise 6ecause oi the <br />installal�on and mointenance o( the improvement hereto applied for ond <br />further agrees lo remuve same upon nolice from ihe Cily and to replace all <br />public property damoged Ihereby. <br />�.� <br />�,GLu�,n/� sa3`/3� <br />Inspeclor's Signaf re � � � � <br />� � ���� <br />-7' <br />�; �',t �,7f;2��1�� . -5 , <br />Dafe <br />�.ac: c <br />�r,�t�n <br />� G. <br />(�_ Cr;�CK WITrt ��.rA}�� <br />L'CPT. FOR VJATER UNE <br />l! CATIONS BEFORE EXCAb'ATION <br />: �„ ' � �� <br />Variance Required <br />Yes <br />No _ <br />X <br />$ign�!ore ol Applicanf <br />/L � <br />Address <br />� <br />ielephone Number <br />Dale <br />s Na F�E. <br />I <br />Fee <br />,� : _ � � :��� <br />Engineers��1 <br />Waler ;�:�. � <br />Strcef �i:..�1 <br />' Commun¢ufions <br />Trafiic � <br />Plonning <br />v, _I� C <br />. . _ �_ ._Fr� <br />