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� <br />Date •�%%i�r,P%i� /�� �7•S� <br />� �v - 2 3 � ��G� �� <br />A?Pi,ICATICN for > � � ��_�_ _ � <br />The �dersi�ed owner hereby agrees tc hcld and save harmless the City <br />of �mrett Srom any and all clains for damages that may arise bec�use of in� <br />sta},lii.ion cT tha improvement hereto applied Sor� and further agrees to <br />remove svne npon notice from the City and to replace all public piroperty dam- <br />�ged thereby., , <br />��-lC�-S� _ <br />..._.........._._._..._.... � <br />�re<;e ��' <br />��r,�d;,�� <br />�� '�r�-n.7� cr�-�.2ah o��?.ht� <br />-�-c.��� r', ..i.�i � f.�.� .��-;::�i L . <br />�/I^� l�/C?�C�illr� �!l.i��l;'f ��/i� �'li:./.1 � ^ ����/ <br />� � r�_ <br />Si gn�d <br />h�l!1�� 1., ���U <br />�arrzo•: r�� ..... . . ...1......,.... . <br />......... . ....... . . . <br />.....u,.�T <br />................... .. . <br />.. ..... . ci:, utcx► <br />�GLt.l%3C �02' <br />