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At the foilowing location `� �`�� � � � ' ` " ` �-- <br /> _ , <br /> SKETCH I � "1 <br /> (Work to be done) /cS Q Vl <br /> .� � J <br /> , ° ` � <br /> ; � � <br /> � �a � � <br /> I I � � al� I <br /> I r � I I <br /> . L�I � y (v� � <br /> j V �. <br /> / I � � � 5 G, /_�L l= <br /> � � � � ' . �=�, <br /> � I � �� <br /> -s,� � <br /> �L� � <br /> �� � <br /> �v <br /> '�L <br /> � <br />; Thc undersigned owner hereby agrees lo hold and save harmless the City of Varionce Required <br /> Everelt from any ond all claims for damages Iha1 may arise because of the . <br /> Ycs ... ...._._..___.... <br /> inslallalion and mainlenance o( thc improvement hereto applied for and <br /> No_._...._....____.... <br /> furiher agrees to remove same upon nolice irom the City and lo replate all <br /> public property damaged thereby. <br /> �' <br /> �!-1 � ' ' . �l <br /> � �� i <br /> � 1.���-IC��_� �;.�Il�l. � i'�:�7 �. ,.��;,� <br /> - � Signafure of Applimnf �� <br /> / I <br /> �.7 � � C:; /�-'��� �C . r � .� �.. <br /> Address , <br /> �-L -�` �-"'-`{3;, <br /> ielephone Number <br /> � „ C, <br /> �-� C� l.dLily � ^� � % �' _ <br /> /,.� / '� Dale � <br /> �y� � �--' ' / ` <br /> ,/.�[�_�/-"t/..�". � �t.-c[,y/�-�-> .,G <br /> Inspecror's �' �afure ,f � �� -- � <br /> i <br /> �/� ��y Fee <br /> D"afe � <br /> DEPT. APPROVALS <br /> Remarks Engineers <br /> VJater <br /> Strcet <br /> Communicotiom �r vy�_ ,r � „ - �*�`� ;y�` <br /> Traffic <br /> Planning <br /> ' <br />