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� ' ' Appro��ed By <br /> .1�fa�C<� � /9 7/ <br /> The Undersigned j - f ^� r ' Dale Approved <br /> Hereby applies for permission 10 ��'<' '�'�. A F:'' ^ '.� r_ ., , n- � <br /> I <br /> i <br /> At the following lomtion /�'�'r =,_ �% ' ' ' �� �'•�✓ <br /> I <br /> SKETCH F�� �'�����. �> �/�A �' �� <br /> IWork to be donel � <br /> - <br /> Z� _ _ - __ - --- <br /> i <br /> i <br /> �- o I <br /> � 0 <br /> x <br /> I �n <br /> � � I <br /> I y � <br /> , � <br /> I � <br /> i i I <br /> 4 � I <br /> , � I ( , <br /> ,_ , <br /> __ � � <br /> � � <br /> The undcrsigned ownen c�reby agrecs ro hold and savc harmless Ihe City of Variance Required � <br /> EvereR from any and all claims for damages that may arise because of the Yes__._.............._..... <br />�i installation ond maintenonce af Ihe improvemen! hereto upplied for and � ,� . No.__._..._..._._....... <br /> furlher ogrees to remove same opon nolice from the City and to reploce all ,.����; <br /> public properly damaged Ihereby. <br /> ~_QF2)V E��I.Y. -�...SfCT.IRIti ,p{�IVE\JAY�..�SGC710N=::'" �� <br /> (tJD��_�SCAGS� . ' � / , <br /> C�i� G'v' - �%tJ�� <br /> �— � ^ Signafure o/ Ap�licanf <br /> M �-�-... _.�_'"''_ � � <br /> �"�� 30 �-- -- � ---- W � C D .`L �=J/clr�Gcr/tL;� . <br /> �-- - -^ " Address <br /> •----4_'L_ P/t. � <br />'� � � - �i�-,r � <br />� � Telephone Numbe� <br /> O::T�.csls').- <br /> Dale <br /> Inspecfor's Signafure $ � <br /> � �� �- <br /> :,�/T[Y� �i�FC.��l� `3���7/ _ Fee <br /> Dale <br /> DEPT. APPROVALS <br /> � � � <br /> Remorks �'-.Ef�*��/ �`�/'�/7/ <br /> Engineers ���% <br /> Waler i �✓r ci'i") J--7:-- 7 ; <br /> �� i <br /> SIreM <br /> Comm ���i'�o. T�r I'��.....�`S <br /> TraHic �.��. �' :yS��..� <br /> Planning ,"�/�'�' <br /> �all Engineering DepL 2�9 Eg03 ' fVOTE <br /> PROVIDE FOR CHECK IVITH WATER <br /> 24 Hours before PROPER DRAINAGE �[PT. FOR WATER LINE <br /> �op5tluCtlOq IS St�ffCd, �OCAIIONS pEFORE EXCAVATION <br />