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.. ,_ ...0 :;t-r7F.tiCE TIL1T ;�:QII=F".':r'vT <br />. -.,.. `i_ ..._ � _'i i: T 1ir ` .. ...:):. it;'3 nr <br />, _.i; U:JD;;ItW'R1TEi:5' L9130i2ATOR`l. <br />i;:�!�: C:'i0^i O':' SiGN PL:QUIRLD <br />��__ �:_:i. ERi.CTION. <br />G�LL 2�9-8 i-i5 I� OR I�15Pi.CT70N. <br />. �`�/-� � <br />Date L1nr! l ,� /�j' �,S <br />.�.���_��� <br />APPLIGATION FOR q,?�S ��rcG� �� �'L. -- <br />Thc ur.dersiCned owner hereUy acre=_s to hold ar,d sz��� hurmless the Gitv <br />of .''.verett irom any and ail claiin� ior uarrr � that r.,a•y a:ise hecause o[ <br />i::stallation o.` the im};rc�ement hcreto aat .ic� Cor, ar.c: fc:•ther agrees to <br />remo��e same unon notiee irem the Citc a;, i to r�p:ace all n•.iblic propertp <br />damaged tnereby. <br />�,00 <br />VALJE: p� <br />Signed <br />,3�„��� u.c v/s./„" <br />a l�l �- �f1-7i' <br />CIRCUITS: <br />���. /3x �' Z <br />�a/lrpu.ic^C�. Lc%r� <br />7s 3 -`>cnr <br />% �0.3 E <br />Oavne r <br />Contractor <br />