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SIGIi I'ER:�tI'i APPI � ^ATION <br /> � - ' SUf4?iTT EVIDC;7CG TIi�1T I:QUII'Nii�C <br /> CO;fYLIGS {:ITII Tll'3 L'T.1�D.1!;llS Or <br /> AK AI''Ci;O�'F.D TLSTIt�G LaBV:.�'IO;:Y . <br /> INS}'ECTION OI' SIC.H ftEQUIi:I:D <br /> OF.FOitC t:P.LC(ION. <br /> CALL 2;9-9745 FOK ItIS`.'EC'fl0i�. <br /> APPLIGITIO\ D�+Tf �� ,� . <br /> ADURT.SS /'^ -' _ — <br /> Tt�c undcr;:igncd ow:�en c�rcby a�,rers eo hold ar.d save h:+rnl.ess the <br /> City of }:ve[ctt. fror an>' and a11 cl�ir.iti -o:' da�o�,^,r.s Chal ma}' �rise , <br /> bec.�use o£ inscailal'iun o+ the fc;ro�aement hereco applied for, aad <br /> `ur[her agrees �o remove sa�.�e upon uacice :roa the Ci.ty ca nnd to re- <br /> pincr_ al] p',�hl.i.r p:uperty cL�.:ap.cd '.hcreb�. <br /> �,� <br /> VALU�: ���'' ' �' - . <br /> CIRCUITS: �:' � <br /> �, C L� <br /> FEE: <br /> EL£.CTRIGIL: r=� '��"� <br /> n� ��C _ <br /> TOT�1L kGES: I � - <br /> / . _•� . . , . . <br /> � . . <br /> 1�� . 1t <br /> I - '� . <br /> I _ " I. Lt , � . , .. <br /> . , � ,,, . . . <br /> I <br /> �v I`i+ s, 'I;; _ . , _ , <br /> . ,r, . __ -p . . . <br /> - � Y. � <br /> i, ���., ', . _ .._ ; I� � .V . � � . _ .. <br /> . .'i.t'' ' � ' �. _ � .. . . <br /> Cv !� <br /> �, 1'- 3 - z�� 78 �� � . <br /> r� � ' n <br /> =� ` �_',v 7`d a��L , . <br /> � • � Zi <br /> �� ` , �., � .; , <br /> � <br /> 1 <br /> � SIGNED 0+^dF.P. � <br /> �' � <br /> � COPiT1:ACfOR ' � — <br /> � l - <br /> T.ICL�Sti K0. � �,;' <br /> �� � . ': <br /> �\ ' <br /> � <br />