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/Zti/u /S !7r- A!5 <br />Date _ /I - - 68 <br />�17 Y <br />APPLICATION for _a�/cnc;7,L1' 1%/f �/� 74 Fi%Fsf]%'r.- Sily .ear �Y: i/7 ✓E `YF_ <br />The undersigned owner hereby agrees to hold and save hafmless tfie-City <br />of Everett from any and all claims for damages that may arise because -of - <br />installation of the improvement hereto applied for, and further agrees -to <br />remove same upon notice from the City and to replace rll public property <br />damaged thereby, <br />T'zXA Cu <br />� � Fxrs�7ti� <br />/4f <br />X �'X' Z'' L A%N/h. EXIyWS�•J <br />ir-4. <br />� L <br />Signed Owner <br />jgtnl.P! <br />contractor _J9 y/e4 / <br />