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<br /> Thc undcrsigned owncn c�reby agrees to hold and savc harmless Ihe City of ' �U I� Vd� ncc Required
<br /> EvcreN from any and all claims for damages that may orisc bemusc of the ,��/ � U ' Yet._..
<br /> installalion and maiNenance o( Ihe improvement hcreto applied for and I� �' ' i� ,(� � No._ �..��...�......�.....
<br /> lurther ogrees to remove same upon noticc from the Cily and to replate all ��
<br /> public property damaged Ihcreby. (� �( � ((/� �/�
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<br /> �\ NO SCALE �O �" Signalurc ol Applicant
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<br /> � /� Address
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<br /> DEPi. APPROVALS
<br /> Remorks
<br /> Enginccrs
<br /> Watcr �
<br /> Sireet ;.��--�GC. , �>_.�i.';� '.�—
<br /> Communications � � '�-�
<br /> Traffic 1'� � - .
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<br /> Plonning
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<br /> 'ROVIDC FOR
<br /> Call Enp,ineering DepL 259�r�I:S � "��TE PROPER DRAINAGE I
<br /> 2•1 Hour.° '�xC '�Hi_CK 1v17H WAT�I2
<br /> construction. �arted. DEPT. FOR 1"JATER UNE i
<br /> ""` �-OCATIONS f3FFORE ['/CA!!r1T10�'
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