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r. <br /> ' � <br /> The Undersigned '� .� ��'�- �-c��5 � C c,. Date Appro�cd <br /> Hereby applies for permission lo_��o a �P�' •• • r - � �,- :. , - ' ' <br /> i � <br /> At the following location �' ��%: � - - '',�. - . <br /> , , - � , ; j i , ii '%'- ��� L.h,;. <br /> SKETCH <br />, fWork to be donel <br /> Col � }' ,pu �. "" <br /> --r-- _— --- . <br /> �>_ , — o i <br /> �1 z_ <br /> `— �qo oSe� � �,� �� .� �� r <br /> I�= 40 � P ^,. �' <br /> UNOEAGPOUND _�".—.. � <br /> CoNdu�f l���'�,,.r' <br /> 3 DeeF � i i <br /> � <br /> 34�� <br /> �I <br /> � • 'S <br /> - �--- -- _ .. _��._�_.___� I r�• <br /> — _ — . _ . _ �F� Pcl.-= ' <br /> _..__ . '.'� � <br /> I i I <br /> I i <br /> The undersigned owner heroby ogrees ro hold and save harmlesc Ihe City o.` Variance Required <br /> Everetf from any and all cloims for damoges Ihat moy a�ise bemosa cf Ihe Yes <br /> in:tollofion ond mainlenonce o� ihe improvement herelo applied for ond No .. <br /> forther ogrees fo removc some upon notice Irom Ihe Ci�y and to replace oll ---� �-��"---�-- �� <br /> public property damoged t�icreby. <br /> ��� ' ? <br /> � <br /> "�//Q/2C,'_ ���G�..'-��.' '�1�1,i . <br /> Signolure o1 ApplitaN � <br /> ��pX�/S � ( L'i[t �9 , �ii <br /> ' Add�ess <br /> �'-.�,y- si�i <br /> 'Telephone Number <br /> ��� i�/ �'—(�.T <br /> � Dale <br /> �.�' , <br /> Inspeck�ri�"$ignolure . � $ <br /> Fee <br /> Da�e <br /> DEhT. APPROVALS <br /> Remarks �, �� <br /> Enpincers <br /> Waler LU� -�•�%y � .I.� ' �� <br /> Slreet •�� . .- /'1 iot ... ,kl�9 ' <br /> Communimlion <br /> T�atfic � <br /> . Planning ��� l . �'' <br />