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SKETCH ; I — -- --- <br /> (Work to be donel � o M /�/J EL�r'' !.�1 / <br /> � U �• =r %�:.�' ; ; / " . . . � , <br /> ' PR�VIDE` FOR <br /> – ---- -;�0�-EI� D^hiivA�� <br /> 76' 75 <br /> �, S9pQ- �— <br /> ` — <br /> i s.4 � <br /> __ _ ------ _-- ' ,lS-�AGT D,2/VE. <br /> _� ^� <br /> „ <br /> ,� ,E, ��f 1 G; �,4�,q .y' I =�c I �--� <br /> �. <br /> --_ <br /> The undersigned owner I creby agrees to hold and save harmless the Cily of Voriance Required <br /> EvcreH from any ond all claims for damoges that may arisc because of thc Ycs <br /> _._ _._. _ _.. .... <br /> insiallotion and maintenancc of the improvement herero applied for and No_.. <br /> further agrees to remove same upon nolice {rom the City and to replace all --�� ���--�-----�-�-" <br /> public property damaged thereby. <br /> R�c�ti�,u�a/p il�4T t/�is %��i'FrlT <br /> , <br /> f3k S��NED � No r%',+4�oBG.E�/S _ � ��_��, �� , ;., ,. <br /> �,J/�.�3 L Si4nature o( Aoo6mnf ' <br /> //:�+ •��'G'/�q � <br /> �� _�.���_U , � , -�,M . , . ,' <br /> �'.,t� llJ .,C��ir_�n ;',..�_cCi, . ��.�.�_ '!'� Address � <br /> S/9�e ,�'o �Lc�� - c�,z.r•� . m . <br /> ,- <br /> � ���J `�/ �� �///J�����"� Telephone•Number <br /> ���� ` /"..�-1 ����.-C �J�!�,L.["�T ' � ,. , <br /> ')/ G�Gl C'C7t�,� ' . /�G.3��D <br /> —T- Date <br /> Inspedor's $ignature S • -'- f' ,.,-�--';' <br /> —� <br /> Fee <br /> Date ---- <br /> � <br /> DEPT. APPROVALS <br /> Remarkc <6-'�'! /j�%"r' � � )de%�.,�w�-t.' (�.Ei/ � <br /> � Engincers �- , �_ , �n , <br /> Water L.�i�i :7�r-c' I <br /> - Stree1 <br /> i t1 <br /> Commonicalions <br /> Traffic . . . <br /> P�anning <br /> l /�� <br />