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t I c o owing ocahon.-------------- — — <br /> SKETCH <br /> IWork to be donel <br /> :' I <br /> � <br /> / / I <br /> � <br /> ,'- �'`' � <br /> r� � i / l <br /> _ � _ -i� - -�-- -__- j ' j � <br /> / � <br /> - - �' '- j <br /> . � -\. /�� �Lv I <br /> . ___._ _ . __ _ .__ - __� . • <br /> �� � <br /> .._ ____-._ ... .._ _ . _._.___-_ _ ' ..- -- - . �,, / l�j <br /> - __ �, 1 i <br /> / <br /> [ .r1ERSON PLAC� tna; C <br /> i• " <br /> . <br /> - - —�, :. <br /> �'' <br /> ( I <br /> �� <br /> \ <br /> \ <br /> � <br /> The undersigned owner hereby agrees ro hold and save harmless �he Ciry of �'. � Variance Required <br /> Everetf from any and all doims for damages thal may arise because of thc � Yes.._......._.... ._...._. <br /> installation ond maintenancc of fhe improvement herelo applied for and ' '�, No._. <br /> . _....._...._....._. <br /> further agrees to remo�e sam^ upon nolice from the City and fo replace all 'I ' <br /> public properly damaged thereby. � <br /> I � <br /> QRl.v.EwJhY:`�=5[C.T.10N � .� <br /> �AI�.-rSCALE) i `-" �.�,j,V GJ � `.f, . <br /> G'� / .., <br /> Si ature of Applicanf <br /> i <br /> . <br /> t ; <br /> I 1'''�`' - --� _. ._.._._�__.__._ �°� .,�i � %,�(� - 9 1���.0 f., • � .'/ <br /> � �. �V : u � � add�e,: <br /> � ' (�-:_,..::..:�- .JJ'S ' ���� ? <br /> Telephone Number <br /> _�_ �, � 7/ <br /> Da'e <br /> 5 � _ �-'!1 <_� <br /> Inspecfor's Signature � <br /> / Fee <br /> S/%/E �/�1�G.�i'�/] �-���g-7� <br /> Dafe <br /> DEPT. PPROVALS <br /> ri : -j r <br /> ` �i � /f7/ / <br /> Remarks Engineer�� L� <br /> -� Water� .ca%-�.-._:., f-- :.'/ ' 7/ <br /> Slrecl ✓._.-----�--�-------- <br /> Commonicalio _ <br /> Traf(ic - �='�' <br /> Planning � � � `�' �' <br /> __ —'� I PROVIDE FOR <br /> Call Engineering Dept. 259•BB�, � ���= PROPER DRAINAGE <br /> 24 Nours before ' NOTE <br /> construction is started. ( / CH[CK WITH VPATER ��� I <br /> "'. FOR WATER LINE � � <br /> ` "'�. BEFORE EXCAVATiDPP '� � _ <br /> • \ __ _ <br /> �_ _r----�_.—— — <br />