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(Work to be done) <br />A0 SchtE <br />=_'i �v��__ <br />3a <br />GqR?.6E �p� <br />�CP <br />�� <br />n <br />�2 <br />0 <br />N <br />� ' <br />c�Te2M <br />� SCNER <br />/�LANTING ON <br />,9/� T.� nL:'y <br />5To R �� <br />�Scv,EK 3Q� � <br />iz" c��verx�� <br />The unde�signed owner hereby agreNi1Mo hold and save harmless ihe City of �1.------�"�— <br />Everell from any and all claims for damages ihal may arise bec L1Frr•'�"� <br />inslallafion and mainlenance of Ihe��i prnuwnert rero applied for and �O V 1� H �3 �� �D �'� A`� <br />furlher agrees to remove smRe upon nolice from ihe Ciry and to replace ali � <br />public property damaged thtreby. <br />. ._ ,._ .. .. .. .. .. ._..w_.__._..___.___. <br />� � CaF'lt+ !. :,�C710N <br />`__oF;;u�� ���•✓. �,_r_7rr.�i,�_:. . (,J�:=�catE} <br />�_.^_ - ; � <br />t':' ��'i <br />- -•--- --- <br />.._ . ._ '.—.'_' � ... _ <br />� \ 1.1 1 �.I <br />__...._. . _ _ ___.._.. _ _�..�J_._.� <br />Inspedor's Signature <br />Sir� C".y'��,� ��� ��n <br />Dafe <br />//, <br />+ ,� <br />n ^ � 1 � ��' <br />� ' j <br />�' _!' ^!�4._. �-- � <br />� � _ �_._._. . __ ___. _�._..� <br />�3 �'��� <br />�P�"�'1//�-t� �s✓ lL%A,Bi'�i'�— LAiI.lASCRA-P�d/,.5_�N1� <br />CvL✓r�.,e; ' �-o .�.� Go.y,p.czr� .�,�aa� � Gr�/�s: <br />R,v� �Sov:� -S: D.•z. � ��UP��'�'i <br />Call Engincering Ucpt. 259-8803 � p�OViDE FOR I <br />24 Hours before I PROP[R fJRAINAGC I <br />construction is started. <br />�,a;::a: <br />Variance Required <br />Yes...... <br />No....... <br />�i <br />Ci7y PiZ�.? <br />�p� C <br />_' CJR� <br />� <br />; <br />� � _�,� u_<<����_Z <br />Signalu�e of Applicanf <br />[ _�,i�. �'.��x \'-t1 ti �3�'l � <br />1 Address <br />� � ��-� - �.- -�,� �� C, <br />Telephone Num6er <br />�' /O�'.f?/70 <br />- r � <br />Dafe <br />S ��.Z � l�.� <br />Fee <br />DEPT. APPROVALS <br />Engireeri.�'Cf J" .i /f�"'Q %U <br />Water <br />Sfreet 6-E`f .� titi' <br />Trofiic_ <br />Planniny <br />` Nt�TF <br />�` ��''� INIi'H WATER <br />�'�.=L FnR yyqTER UNE � <br />L� `'''T��"!5 BEFORE EXCAVATION !`"'I <br />_._._. -------_ _ _ _ ,__... _J <br />i; <br />