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Herooy applias for permission to '' '` �- il' � ---- --- — <br /> At the following bcation "� �' �'� — -- <br /> SKETCH <br /> IWork to be donel <br /> ,r. <br /> The undersigned owner hereby agrees to hold and save harmless the City of Varionce Required <br /> EvereN from any ond all doims for damages that may arise because of the Yes.......__. _....__ <br /> installa�ion and mainfenance of the improvemer,l herero applied for and � No_.. ..._... <br /> further agreez to remove same upon notice from the City and to replace all <br /> public property damoged fhereby. <br /> Signafure ol Applicanl <br /> Address <br /> Telephone Number <br /> Dofe <br /> � ��-�y <br /> i�,�m; �9��Wa s <br /> `o/a��9 F� <br /> Da�— <br /> DEPT. APPROVALS <br /> Remorks Engineers — <br /> _ Wafer � � � /h+� <br /> $�reef <br /> Communimfions 'E�� u - � �` — <br /> Troffic <br /> Planning <br /> �� , 3 'i <br />