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Af �I'.e iollowing localion , <br />SKETCH <br />IWork to be done) <br />.�--'—�----1� <br />�� `0 <br />E � E R�REE�.v <br />,G,��'MJA/G aT <br />The undcrsigned owner hemby ogrees to hold and save hormless Ihe i ai' <br />[verett fron� any and all claims for dainages that may arise because o( the <br />instollation and mainfenance of Ihe improvemeni hereto applied for and <br />furlher agrees to remove some upon notice irom the Cily and lo .eplace all <br />pu6lic properly damaged Ihereby. <br />r_r����Y. _.s�r,T'tOM <br />( TdD.-_ -:a CAI. � ) <br />�«� , ._ _� <br />�.�......w_,:.,1-.�!.! �ry..,���_ — r <br />A�.u�.��.-..�.... �,��� <br />!� ; �o' <br />9 <br />Inspedor's °'yaalure <br />y`� ITF� ChriiC�`2lJ�[-7� <br />Dafe <br />� <br />l,(�QV r" ��6Gw�/�1�' <br />V � v <br />.� _ Z c <br />1 � <br />V � / ✓' <br />f <br />�vAY <br />Variance Required <br />Yes....... _.... _... _. _..... <br />--�_. No..._......__ ............. <br />/ / .�' :': i <br />✓ i <br />7-r. c'-�..�_. <br />� Signalure ol Applicanl <br />Water <br />Strecl . <br />Traffic � <br />Planning <br />/� �, %S�' - L-��_�-.�f <br />Address <br />��-; - y��� <br />ielephone Number <br />�-//-�� <br />/� oa�e <br />� ��C� � f!'._. _ <br />Fee <br />,,-�,�r�CE_—�:�, . __..__. <br />Call Cn;�io-�cring Dept. �253�8_��03 ' id�J ; G;' `. ._ , ,� _.�. <br />• �-:.0,•�E', 1;i.;.�,.;'.�:�. <br />`[:�i HOl1f5 �B�Jf@ ('.i-iC�fCV�!IH'c�::�TL12 I . <br />con:'.cuction is st�rteB. D�; i. PGR t�+'�.7"cR U�dE I <br />1,�:.;',;'�:'�i.i � �;':F'ORE EXCAV�TlON ` <br />_ _ _ --- . . _,_..I <br />� <br />