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<br /> The Undeni�ned_ _ -- �' - '' = �- : -'-/' Date >pproved
<br /> Hereby applies for permission to C O!->_: %!-�� � / � ` � / -
<br /> � L�a �sc�.P�
<br /> _ � �--, ,` ,��r- T� ,[}l/�
<br /> At the folloviing location � ' ^ �= L-
<br /> SKETCH I i j
<br /> IWork to be donel —� "'— �v '
<br /> Nr. �ut�E 8„' _
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<br /> . . . FE?A�NING WALL rI/�I►�//► .
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<br /> � ' w,vZErl MAin� � � 1 �
<br /> �� oN c�z�-r� �
<br /> �O�'� CGI�J' -. L ,,. , , ,
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<br /> The undersigned owner hereby ogrecs to hold and snve hormlc:s ihe Ci�y of Variance Required
<br /> Evereu irom any and all doims 1or damages ihat moy arise becouse o( the Yes ..
<br /> . ._.._...___ ....
<br /> inslallalion ond mainlenance of Ihe improvemenl heieto opplied (or and
<br /> funher ogrees b remove same upon nolice (rom the City and to replace all No.......... ....... .__ . .
<br /> public properly damnged thereby.
<br /> C , r. � - . .. r.�:Yti�.� � � �
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<br /> DRIVEWAY SECTION
<br /> NO SCALE " ' '� .: ..'. ; ,_
<br /> � . Signafure of Appliconl
<br /> �� � � � ,:j(� �%� �� j �
<br /> I" LIP AdArest
<br /> 30" _�_30�� _ _. . .,
<br /> - r-,
<br /> ' Telephone Number
<br /> Dale� ,/ �
<br /> .�c,,..✓ 6 -',.� �f� �P,. �rx .!J i!� �" J Q� �
<br /> Inspedor's Signatvre �� � 'y ;- -+�--
<br /> �J �S �
<br /> �/TL`' �ii�.�C/��� T/J' /1� �,, Fee
<br /> Dale
<br /> ' � ,� f f � �D Pi�PPROVALS
<br /> :/-rn a!r':Y!%.: t �"M. o%�:��- � � Lw p�I�l �.y �y� /� � , i
<br /> � Engmecrs L������ �. � �> •
<br /> Remarkc C t sc. ��:' i �
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<br /> �''dG� � li.�i> �� I.J nr .uir,fl� �__. '� Y� _� �_ , - Streclr {�"�1 �/�� ���'�y-�+c�.Pi1-
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<br /> Commonicatio i %'.��.��
<br /> TraHic�� � ..
<br /> Plonnin �+�--,' ".���`'
<br /> PROvID� rOF - - - .
<br /> " NOTE �'R�PFR DRAINAGE
<br /> i;all Enrineen���; �):�;��. 259•88U3 CHECK Wi1H y,rqT�R
<br /> 74 Hr.�t; i�^i�.re DEPT. FOR WA7ER LINE �
<br /> cr�ndr;��i� i iy� ted, LUCATIONS QEFORE EXCAVA710N `
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