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Date /��% =� `� <br /> APPLICATIUN FUfv .�� y .1� ;� /r-�t. ' 'J <br /> ,,�.,,_,L1„�(� ' �' r�, . '. %. ., ,�-�-�, , _, _ . , � . �.�: .. , .. ' / ��j I <br /> The undersigned owner hereby agrees to hold and s3ve harmless the Ci{y ���/l � <br /> of [verett from any and all cleims Por damap�es th�t may arise because o£ � <br /> install•ation of `,he improvement hereto appl�ed for� and further aprees to <br /> remove same upon notice from the City and to replace all public proper{y <br /> d-umm,�ped thereby. �� � c <br /> � l.,� �r _ i�J c - - � .. <br /> ¢/� I � a <br /> � (p i�(_�,t - ; ClJ'J ^ � <br /> � �. <br /> _ _ "'__'__ �'-(� � <br /> --. �� <br /> , , <br /> c ' <br /> �.` 1 � c/o�.,- _ ,_��, �,�_, <br /> r�", . -. ' r �`—::t,.1-- � - - . . <br /> � , •� aJ I � '� 1 pe�- 'yl/�,�if9 SCC'/� /r <br /> • I,'r —�__ _ �J '�9 / - ___-_ '___'___ _'P <br /> I� I <br /> �__ _ �-. <br /> i �r1--�^,;� � <br /> �` 1 <br /> I � <br /> I I <br /> 1 � � , � <br /> 1��;�'� /r;,''� <br /> i � `:� �. <br /> � <br /> , <br /> A . —. �.__....���.__._.. I <br /> A <br /> S i gned _���/J s �q� ---��/�'r� J�er <br /> , .. ,.'i ' , �• , . , �1, . ; ,. . , . �ir� ' - . <br /> _ Con{ra�{or <br /> �/ i� cT�'.ti�'�c�7;��j ,�.,...G/�„�kG'.�c�.�s .,»,�:L.;.. <br /> �r lLr3� � � � � -- <br /> ��: : <br /> `. _ <br />