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— — — `- --- — " � � `�KlST. /. ;.. /i"'. �_r - ,. <br /> �.%c S`�f✓� �v�. <br /> - � �-�-�—PRov/Oi� l2 � cu�Ue�r�' �O'r ,� v �� ,� . <br /> b 1' ' -- . <br /> -_y, t`- ___ <br /> r✓s�,,4� ;�' . -� �>: >��� ::i v& ,.�,� y , <br /> � <br /> -.�` <br /> a <br /> � <br /> __-� -f��7- <br /> I <br /> Variancr, Required <br /> The undersiqned owner hereby agrces lo hold a�d save harmless the Cily of Yes. <br /> Everell from any and all claims for damages Ihat may arise because of Ihe No._.. -� <br /> installafion and maintenance of the improvemenl hernto applied for and ��--�----��--- <br /> f�rther agrr.ec 'o remove same upon notice from the Ci1y and lo replace all <br /> public prop^�ty damaged Ihereby. <br /> � / , <br /> �� -� i ' � /� ��li�an../ <br /> � �.1� .� / l�-l�"l�' �—�— <br /> Signalure of Applicanf <br /> � <br /> �� 3 � i �,� ��,.v_� ��,��_. <br /> Address <br /> S .'� j :i <br /> . ��- >1�- - C 7 -� �r <br /> ielephonc Number <br /> L:. _ � �, _. i�� — <br /> Dale <br /> s � °-°��r�;/_q,� �1 <br /> InspeUor's Signature <br /> Fee <br /> LS/T�' C<,/EC,CE� 8�g�7/ <br /> Date <br /> DEPT. APPROVALS , <br /> � '�r , - <br /> Engineer� ���,_ r/FJ.t f <br /> Remarks 1L��� <br /> Watcr <br /> Slrcet % I : - � i .. ` . `" <br /> Communimtion � ES� /5' 7'l ' 71 <br /> ._� , <br /> TfOf{IC � ' ' ; � . . <br /> Planning —z'O� <br />