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J <br />Date %l xtt-- /&/ <br />APPLICATION for � <br />i <br />Al <br />,� Q-Lvi-I'l.l 2t�vsL-l. v%i�L•�../ c7 .Ll� <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everc'.:t from any and all claims for damages that may arise because of installation <br />of the improvement hereto applied for, and further agrees to remove same upon <br />notice from the City and to replace all public property damaged thereby. <br />OR)"., z <br />VPA <br />C�- <br />X Signed <br />t � <br />C'n m M <br />zi <br />li <br />.I. <br />ax1.5i/)'IG <br />Contractor <br />-Lobet'ion Apo metl [Yr� <br />Inspected...4 �`...... ......-- <br />........... <br />