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Hcreby applies for permission to_.::� �L1 �:� �, <br />� .. ._ "'/J'�.'i.�- . ,�.., <br />At the following localio.i �,�,L; � `� —�� �� �' � v'"�–'' - <br />SKETCH <br />IWork to be donel <br />�� :_ _ . .%. B L +.% D <br />, � _.� <br />The undcrsigned owncr hereby agrees lo hold and savc harmless thc City of <br />Evereft from any and all claims for domages thal may arise because o( the <br />ins�allalion and maiNenance of the improvemenl herelo applied for and <br />(urther apiees to remove same upon notice from Ihe Cily and lo replace all <br />pu6lic properly damaged thereby. <br />lncnectoi s Signoture <br />s�r,� CN¢C.t.�Qi� `I-�i-1/ <br />Dale <br />� �VOTE �=- <br />�'+�CK WITN WATEI7 <br />'� rnH �����rF� uNE <br />� ,^� CvcAvnT�nr.� <br />N�. ;�ia�r.�;i� E- <br />Variance Required <br />Yes <br />Nc <br />i <br />��E Nf Y � �Uc .�, �J <br />�,, � �`/ <br />'(:,,�� <br />,��'nLt/ < � �'��. ;;' �� / <br />Signafure ol Appli anf <br />�i�( i ,f_J,,���_ /�/-. -� <br />Address �— <br />�,.L;' J� %i �� •- —� <br />c � <br />ielephone Number <br />Datc <br />$ / . �i_1CL- <br />Fce <br />DEPT. APPROVALS <br />Engineen`,,"r�-� � � ;��1'/�7/ <br />�, r i.•, _�. � i/ -- � J � l. i <br />Walcr'_ <br />Slrcef � 1�� � . "� '" <br />Commumtalionz <br />Traffic_ ` --- <br /><;. �— <br />Planning — <br />