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SKETCH j � <br /> Iwork to be donei �p i <br /> I <br /> � � . <br /> � <br /> II �ia �cnLE <br /> � <br /> I GpQ�E <br /> i r39oG � <br /> 1 _ _ I <br /> i <br /> � <br /> I <br /> I � <br /> � � <br /> I <br /> ` ,L� <br /> -._.._____. p.A'p� <br /> r <br /> EMETzSnN p�.�GE <br /> 'he undersigned owner hereby agrces to hold and save harmless the City oi Variance Required <br /> �vereR from any and all claims for damages Ihat may arisc be�:ause of ihc Yr.s._. __ . _. _.... <br /> inslallalion end maintenance of the improvemenl hereto opplied for and No. _ . .. ___... <br /> further agrees lo remove same upon notice irom the Cily and to replace all <br /> public properly damaged ihereby. <br /> GAtYE�+hY. -�_:.5[Cl'lON /y � � �� t <br /> (N0.'_--SCALC� �- G�� �� � <br /> . Sign ure oF Applicanf <br /> K ��L � S /�,o�� <br /> E�=:� !-'-�- Add;ess <br /> :..,.�-._._.,__.,._.__— �•�C:� e <br /> - -:'G_'t1.D ;� 1 •� ` � ( �. <br /> -•r�:,� � ��— —i i <br /> . ielephone Number <br /> �i3 � �/ <br /> ____ _�.�..�_ Dafe <br /> .._._.. ...._—'^-._-' — � ��LK' <br /> Inspecfoi s Signature $ �' <br /> /� Fee <br /> �?F fLE-c',E.�i) -��6 /7i <br /> oo�e <br /> DEPT. APPROVALS � <br /> Remarks Enginee�} , � ����"/�/7r <br /> Water ,T f'i'�'"� 9• /_'Tl <br /> Streel �— --------'----�... <br /> Communications��� ���4 �-�y 7� <br /> Traf(ic ` � ` � <br /> Planning F /'� � <br /> Cai{ Cn�ireering QepL 259S��u.i PRO':�ICE FOR ' ���TE <br /> CliPCI; �'dITH iNATER <br /> �4 Heurs b�for8 i'�i��i'�R DRAINAGE D��T. FOR WqT[R �INE <br /> COOStNCti011 IS SGif1Nd. LOCIITION$ g[FOF;E EaCAVhT�^�i <br /> r <br /> I_ -- �1�` � .. . . <br />