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, <br /> - ------ -� ,,., . I <br />�� � �'��� � <br /> 1 �� — <br /> t ��. <br />�� 2 `�D�J z� �i <br />! 50' <br /> 1 4 <br /> Jl.Oi <br /> J <br /> 1�1� � 'p• �� <br /> ' I <br />� � �:�� �r <br /> _ _L3 E.00 <br /> � ��-�.___�``ro.'i:�%'f�.i-�;�L`' ; . .��• � .� <br /> ,�"��EST I//Ely !�? ;�'; '.:/: �.� <br /> _- <br /> ��` <br /> Thc undersigned owncr hereby agrces lo hold nnd savc harmless Ihc Cily of Variance Required <br /> Everclf from any and all claims for damages thal may arisc betausc of Ihc Yes._._._.__... <br /> ...._..... <br /> installalion and maintenancc ��f Ihe improvemenl herclo applied for and <br /> No _. __.... <br /> furlher agrees to remove same upon notice from the City and to replace all <br /> publit properly damaged ihcreby. <br /> C2 �I � � f/ <br /> �C..� �(_ '�'t . ����r//C� . Signalwc oF Applimnt � . <br /> � ���� `���� Address <br /> .... <br /> �r`� ielephone Number <br /> � <br /> N <br /> .�> -� " Dafe <br /> ��1�2.�-," �� �J�r <• �t< - <br /> Inspedo�'i�5ignafure �=� � <br /> Fce <br /> 7 �/�� <br /> Da e <br /> DEPT. APPROVALS <br /> Remarks Engineers <br /> Waicr ' '�P - <br /> Strccl <br /> Communicalions • � � - %'�•�' �` <br /> Traffic <br /> _ Planninc� <br /> --'7 <br />