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Date/ <br />Y , <br />4/! <br />� APPLICATIDN for <br />y' r ' ° <br />�'ti'. �':f ��`�'✓ ,�� ��_D-Lt-' .r_.��.!-�..._.r t�in.��(LL"(iJ� nl�S-.:ri . wM• <br />The derYn <br />o er heTj�by ag"� s to_ ld and e/aise <br />armless tfie' ity <br />of Evere fr marp all glaims f dame os that y be use- £"insta do of rove ent her to a ied for andthei gre-to <br />remov sam upoce fr m the City an to rep o hli property <br />3 L/ <br />dame ed theroby, T <br />C <br />i <br />Location Approve <br />Inspected — <br />Signed <br />OA f. N. <br />0k. <br />Owner <br />contractor ;,iaR 15 1965 <br />t,it�Y%le�l <br />I <br />