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Date //- y0-(ov <br />APPLICATION for S/Gn/ 56C.>'!o ✓ <br />NAG OvT <br />The undersigned •Dwner hereby agrees tc hold and save harmless the City <br />of Fvcrect from arty and all claims for damages that, may arise because of in- <br />stallation of the improvement hereto applied for, and further agrees to <br />remove rare 'upon notice fron the City and to replace all public propervy dam- <br />ag <br />ed thereby, <br />.Qvr.eox <br />16 Fa Er <br />To GeAPE <br />�> 1 <br />LOU tion.gpproVoAv+eL'!E� z�X,., <br />/O FEET <br />21 "-�EEr H.N. <br />�itiC I �..C'AOE <br />Signed <br />O.K. f<r j.•ol �i o �,L_`L*' �Ct� �!'LGc..r ."l..•.. <br />NoF �ie(rin-reiZ{u� � seWfr 5 l V�, �" <br />2146,010,6 <br />CEr;rJri.vty � <br />A.vbte <br />,Burt orN4 <br />�S.�P,COY/H4TFfY <br />S _ FEET- <br />X2 X AN646 <br />Pour <br />Guy wu�rr �¢' <br />BA• •r/OEJ ATrIGti`e <br />To POIT.� -0NC <br />SG; cu.tE� To <br />r9u.eui.v4 <br />Cnntraat.or <br />