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At the following bcation�`�O 3� F MF_,��OA1 PLAG� <br /> SKETCH • <br /> IWork to be donel <br /> �oT 3� <br /> i T <br /> � <br /> I <br /> � Sqp3 <br /> i <br /> I ��- P�G <br /> yG <br /> I O <br /> ( <br /> � <br /> � <br /> I <br /> � � <br /> i � <br /> �.Pe _ <br /> -____'._' "__' _ .' � <br /> ,�I i�),j,/. <br /> � I�"' � .Gr' ^".j �71`�Vn.� <br /> ��J�j.,r_ i" t <br /> The undersigned owner hereby agrees lo hold and save harmless thc City of Variance Required <br /> Everell from any ond all claims ior damages thal may arise becausr of Ihe Yes.........__............... <br /> installation and mainlenance of thc improvement herclo applied for and <br /> furlher agrees b remove same upon nolice from the City and to replace all No_......_____..._..... <br /> public property damaged thereby. <br /> � {�.F�.1'JiE•a.::y\' '_�C: r�•Ir . . . __ �. <br /> (uro .,scnc[) ':t � <br /> � ��C'��/'� . ����1/�� <br /> Sigriature ol Applimnl <br /> �'�,: — ', kx:__� �s %� �D ` � f�iluy ���,�.,� <br /> ��.., <br /> �._.�_P '." . nad�e:� � <br /> • _�� �J1:7'— �[c.�¢ `z-- — <br /> � Telephone Number <br /> -- ���i•r�-` <br /> �.� ! J .� Dafe � <br /> Inspecfor's Signafure � �� $ / � �— �9 - 9~ r� <br /> _ S'l1fL Ci1,EG.CE1� y�3�i' F�c <br /> Dafe <br /> EPT. APPROVA <br /> Remarks Enginecrt - �� �/''��� <br /> Water A.`�',.� T �!C %- l3- 7/ <br /> Strect <br /> . Communications °�'! �'l C' i'/yY• ! <br /> Traf(ic T'�" - � —�n - 7/ <br /> _ Planning �'� <br /> F'ROVID� FpR —` <br /> Call Enp,in�cring Dept. 2�9.E$D3 � NOTE PROPER DRqlNAGE I <br /> 24 Hours 6efore CHECK WITH WA7ER <br /> '90SttuCtion tS SfBItCd. �«7. FOR WATER I.IN� <br /> - ,._ � LOCATIONS BF.FORE EXCAVATION -��y � <br />