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APFLIC�ITION FUk <br />.n <br />, � .,;, <br />f1� "� <br />/ p � <br />v u <br />p� • / .� <br />/ _ (if"i".� . _ . <br />� �i i� <br />-� / <br />Da{e � Z � –� � ' <br />�`/C c.'(`-�'�C-t'�'J ✓/�"`a"'"— <br />The undersigned owner hereby a�rees to hold and sa�e harmless the City� �J� � <br />of Everett from any and all claims for damap�es th=t may arise because of <br />install�tion of the improvement hereto applied for� and further aqrees to <br />rertave same upon notice from the C;{y and to replace all public property �%'�� ,J � <br />damaged thereby. <br />/% .�/ , <br />��� �C CL �.. � _ �/' � /, � � � q� <br />�� <br />,. ti <br />C�l�i'iu.•� — � <br />Signed <br />,�-�J �`1���� <br />I '�� 5 � <br />o+oroF�� �rca,�- <br />`Xist�n`� � <br />I,.ron,A n� / 5 i G� to � un kzc.� <br />tR ui �c, ���F„��.,:��� /l•4...4a <br />Rc rA,r� <br />n��+ r n � <br />A �2 � �� <br />C��N pITl�ly! <br />--- —��=4� �5' . <br />� <br />�IDC <<�� � <br />'1 <br />`�%�. <br />n�� �� �_� <br />��� <br />o �2 r �.�1 ,t <br />Uwner <br />ractor <br />