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SY.[TCH <br /> lWor4: to be done) <br /> - -- - S-- ,,_:__ __ - - <br /> -__ .�_. �, � --. <br /> -- ELM ,s(._.__ .��� _. <br /> ----- — �a' ` <br /> 1� <br /> v <br /> � <br /> J 47oz <br /> � <br /> �� <br /> � <br /> �'� � ! <br /> -j . <br /> The undcrsigned owner hereby agreas in hold and savc harmless Ihe City of Variancc Required <br /> Evcrelt irom any and all daims for damages Ihat may arise because of thc Ycs......._..._....._...... <br /> installalion and maintenancc of the improvemenl hcrclo applicd for and No.. . <br /> (urthcr agrces to remove same upon nolice from the City and lo replacc all �� ���-����������������� � <br /> public properry damaged Ihcreby. ,,}!j��_1. <br /> �_�.� r:7.1 l <br /> . . F �,-,.. � <br /> -- - _ . , . �'� , CCi �����l <br /> nalu e ol Applitant <br /> 3�n J� .s. �r.+� <br /> :i. . _ _ . I �r/ ��`��cPl'sou., �Po� •q <br /> ; '..� �� '�.; ��"`.. _��._.._.,....__ ---- -^1 Addrest <br /> j�� + �' , � <br /> �'�+`. l g i _�--� �5?i— `��f(0 7 r'�'.,.��-,: <br /> ielephone Number <br /> .__._.__ ��;�/� � <br /> � Dale <br /> Inspecfor's $ignolure <br /> � � � -��, L S � _ <br /> '�'� . / �� � �^ Fee <br /> -`i�iTi� C- -<.�;;e. ,['.ri) ��.�'� ' 7�C'. 7� <br /> Dafe � �'� ���� <br /> DEPT. APPROVALS <br /> L�iy/�i 'i ��/�/ii��•�c� i i _� /r/ / <br /> Remarks %j /;.%.C. /(�.� .�n /v/-I.i r=i:_i� V� Enginees ,. �. % i. . ,�/�5 ��/'l__ <br /> �l - war�r ti �-�- - �i--7�.L�v <br /> j(J3 iC 0 ��9�ii%>i�.5i-I �.C_/•�J. � � 'J J Slrect� �'— � _._-- <br /> Communic 1' �3'ii^.��r c � � _ <br /> - !,; � .-, -r�arr� , —yai 7-�y- �Z <br /> �1,��✓-t� ;/_ i /-� C. /-!.0 i/- r,�. J��--� Planning el 7�^ <br /> �-----------_.. ---. . <br /> ' i��OVIDE i�OFi ( ° (HOi'E <br /> � ` � �; - . I' � �;OPER DRAINAGE I CH[CK WITN WA i qd <br /> ��� F�i���= �°���e DEPt. FOR V.'^,TER LINE <br /> �truction is started. I LOCATIONS �,_pp�E ^•���,:;-��,-;i <br /> } -�-_t--..,...�.�..���.,� <br />