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P.t the fo;lowing (omhon�� <br />SKETCH <br />(VJcrkto be donel <br />' y � - /� i l,s. �T . i -' r'� . � . r. - / , <br />K� <br />�` <br />t� , �� i �L �� - � J� �'T,C <br />� <br />!' I � � <br />_ — �___ <br />l :_ .�� : q � ; �; i i( .,,' <br />/� <br />�Y��'��. / '' , '/�j � <br />o i . . <br />✓ - _ ;. <br />The undersigned owner hereby agrees to hold and save harmless thc City of <br />Everen from any ond all daims for damag,.s thal may arise becouse of the <br />installation and maintenance of the improvemenl hereto appLed (or and <br />further ogrces b mmove same upon notice irom the City and �o replace all <br />public property domoged Ihereby. <br />!1,r i <br />( �/ 1 }rr <br />i� <br />Inspeclor's Signafure <br />Dafe <br />; = 7� .'t-hMY� <br />� ` <br />;%��C. <br />� <br />�C� ; L� � l��'�/<n <br />/jPo.eoX/�i1.�rELY f'�' = _, "-. � <br />_ .-i%r7 ► ' - ,_1._ _ -`- i <br />. -. - _. . , . . . , <br />— - - — �---- /�,eOr=USC[� ,� i/.' ,ti,�r=r? <br />rso = <br />� <br />� <br />� <br />1 .'1 <br />�1 � O,, <br />.j <br />.�.�a, <br />Variance Required <br />Yes .. ._._._....._-- <br />No..... __......_. <br />I/ :/ Y <br />� Signalure o( Applimnf � <br />. .,., � , . <br />- _ - , . ., �, � !. <br />j Address <br />'"�_.,�c t�- ,__,_ <br />).i - " i <br />1 Telephone Num6er <br />/ <br />� -- • <br />�,' - " � f �.� _ <br />Dafe ' <br />� <br />Fee <br />,� DEPT. APPROVALS <br />I�r� ��. _ A i � `- ���... <br />wa��� � <br />Streef � <br />Communicalions <br />Planning <br />