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IWc��: �o __ _,�.. �i <br /> •9 <br /> � <br /> —20.o _ <br /> , �� <br /> I � J I� I N ' <br /> 'i m i - �. <br /> n <br /> i � L��' �� <br /> �)e crA:r <br /> L� ' <br /> ! ` <br /> � �� <br /> i� � � <br /> .. <br /> � ��:: <br /> � <br /> : <br /> - � <br /> The undersigned owner hereby agrees Io hold and save harmless ihe City of Variance Requ:red <br /> Everelt irom any and all daims {or damages Ihat moy arise becausc of Ihe Yes__._...._......_....... <br /> insrollalion and maintenance of Ire improvement here!o applicd for and No .__..__.____....... <br /> furlher agrees Io remove same upon nolice {rom Ihe City and to replace all � . r� <br /> pv�lic property damaaed thereby. � 1a�� ''' t <br /> _ � <br /> LR.1V.fiN/�,Y..��_5lCL/OH _ `��� �� <br /> .ORI�'E\JAl'� S4CTION..:: . (NU."_-SCAt$� , , L i?71 ��%?��vL"C�� <br /> �,C_� <br /> � Signature o( Applicanf � <br /> �"� �" �� „ /�n5� L��/%'Pr�ti� /'L , <br /> ^-�"_.___— a-lo-. !e- CYN�-'cv['l��alffGc'i(SF/ , a�'�- <br /> � w ,.: <br /> ,�"'"_' �_.�(.� ?���� ' / 1/ J� <br /> • ielephone Number <br /> _ ....a�l_ ._. <br /> Date <br /> � , -Z: - , i � i_.. <br /> Inspeclor's $ignafure a � � ��`�""� �� <br /> Fee <br /> S/TG Cr/Eci�FU 3/7r�ii <br /> Dale <br /> DEPi. APPROVALS <br /> — � i�3� �� <br /> Remarks Engineers ' � <br /> Waler . .��..:. .� - > >� �� <br /> Street <br /> Communicalions <br /> Tra(fic ��� <br /> Planning �'"' <br /> Call Engineering Dept. 259�8803 ' NOTE PROVIDE FOR <br /> 24 Hours betore CHECK WI7H WA7ER PROPER DRAINAGE <br /> construction IS Slefied. D[PT. FOR WATER LINE <br /> LOCATIONS BEFORE EXCAVATION <br />