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Af fhr {nllnwin� Intntinn ��'L21 J — �H�n✓'r'O� PL ArE — <br /> SKETCH <br /> IWork fo be donel <br /> EM �2so�� f1.�fc�- <br /> - _ -=-, _ _ <br /> - ' —--- <br /> ;° ---- <br /> �� <br /> , �_�-- <br /> t <br /> -Z __�— i 8813 <br /> �—� <br /> /�, So, � Qz �1 <br /> I -- ---- -- ---- -- — <br /> h°� <br /> The undersigned owncr hereby agrces to hold and save harmless the Ciy o( Variance Required <br /> Everelf from any aad all claims for damages thaf may arise because of Ihe Yes__. <br /> .__......__........ <br /> installation and mainlenance of the improvemenl hereto applicd (or and No . <br /> further agrees to remove same upon notice from the City and to replatc all ---�� � �-��-��----������-� <br /> public property dama�ed Ihereby. <br /> � L�' <br /> .�'��' �L �'� <br /> c . <br /> � afure o( .4pplicanl <br /> ��G -- S ����.�.,4/ <br /> �+�;�. Address <br /> 3 -�S — L� ct �' �-- <br /> Telephone Number <br /> Io - l � - �/ <br /> � oar� <br /> / ao �1 � <br /> Inspecfoi s Signafure S (p — � --�c'r-c_� <br /> _5/T� CffF�!"�C,'F.� ���3�/ Fee <br /> Dale <br /> DEP APPROV�LS , <br /> �/ / <br /> Remarks Enginccrs�C%"�/a�!' /�/��/7i <br /> Water --'�i'.-��. T l0 �� 13—�I _ <br /> Streel_ <br /> Commonicatio�� �-�-'� �a—�'3 —�� <br /> Traffic l ' <br /> _ Planning �f�'� <br /> .—_. ..__.- <br /> Call [n;in�erin.; Dc,.�. :-:i�? t:�03 Pf�OG;i'�_ � , ,, _ . _ ' NOTE <br /> ?+ ��„�:r` ;'-. ' �'P�'��l� U��rUIVI{(G[ CHECIC WITH WATER <br /> cons,rorli�� n is ���,:.I, i DL'PT. FOR IVATER L'��'� <br /> 6r��nTipi:S B°FpRe fY,('AVATIOId <br /> "'�._.._�___ <br /> � <br />