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SKETCH � <br /> IWork to be done) I --; <br /> 1 ySzS <br /> P� <br /> G�� ' <br /> � ! <br /> � <br /> I <br /> I <br /> \ <br /> � <br /> � N,,-��; <br /> � �- , �,J:.� �%�- �NI�)�_�,t_ lGir;r_�; <br /> V /d � <br /> 5f�� `\ ... 7. (� r` t�l-'F.Jh>,�' irlJ�f';l:':> <br /> �N(; f-. <br /> 0 ' � �-,. <br /> � �� . . <br /> ���,�ti`� <br /> - - - =`✓Lr <br /> -`^;�- ,� <br /> The undersigned owner hereby ayrees lo hold and save harmless Ihe City of `�\ Variance kequired <br /> ���cretl from any and all daims for damcges Iha1 may arisc because of Ihe Yes. .__..__......_....... <br /> installalion and maiNenance of the improvemenl herelo applicd for and No. .._. .._ . <br /> further agrees to remove same upon notice from the City and to replace all <br /> _ _._....... <br /> public properly damaged Ihereby. <br /> �/�/��� `4��i�1GG( f� ��/��"�,""� c�(,- <br /> �� �I,�,,.�- r Signalure oF Applicant <br /> u����' ���,,� . �� � ,- �5��,,� N� <br /> L�. .Si�f�r1��(BSS ��fl. <br /> �S� —/ U 2 � <br /> ielephone Number <br /> -> >�� <br /> t�• . .l _ R_ � �.. DiT.PWA� <br /> ., � — <br /> Dafe /G '7- <br /> �- <br /> 9 a'° � '' . <br /> Inspecfor's Signaiure $ � ���— <br /> v <br /> Fee <br /> �.TF �N�='Cr!) `j/�7�12- <br /> Dafe <br /> DEPT. APPROVALS <br /> Remarks Enginccrs �� �''�� " r/���� �����L <br /> L. ._ � - - /� - 7 Z-- <br /> Water__�) � <br /> Slreel —`�T_ -- <br /> Communications � '"` "�`" ^ t'" -� -- <br /> Traffic b/C r` :�"� 3_ � �z <br /> Planning O N S 3�8-�z <br /> , <br /> �t::�—;�' ; C.�I! _ . , <br /> � _JK � iF1 J1,4TER ,, :.. .� .. ..._. . � l.. . <br /> � _ , �,;;c:. <br /> I :.i'T. F'OR �'JATER LINL' i � � , . <br /> t t��-:?I;'r;S 6���(iC• �XCAVA710N � <br /> �� �— ---- i <br /> �_.. <br />