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A� the iollowing locaii�n—__—_�_: _ _ --�----- — <br /> �KETCH <br /> IWork Yo be donel <br /> , <br /> �i <br /> � � <br /> ,� � <br /> j � <br /> / <br /> %� <br /> i � � \ _ <br /> _ . �� � \ � . . <br /> � S I <br /> � r �� � _ �- � <br /> � � �� \ —�_.__.__�_�___� <br /> U \ <br /> � � )� � � fIS�7 �o � — <br /> � p , � _''- - _ ;, ' <br /> .� ( <br /> Thc undersigned owncn c�reby ogrees tu hold and save harmless the City o� Vnriance Required <br /> Evere�l from any and oll doims for damages Ihat rnay arise because of the . _. <br /> Ycs. . _.._ .._...... <br /> insfollation and mainlenonce of ihe improvemeN hereto applied for ond No.. . . .. . .. <br /> furfher ogrces la remave same upon noiice from fnr City ond to replace all <br /> public pwperty damaycd Ihcreby. <br /> '���� � <br /> ._ ,;� �� F ; �.,, i��t- . � , ,' <br /> _/�- <br /> . . ,^.�tl .r S,r.'�'l.� ,.. � ,�._ $ignalure of Applimnl <br /> ! / <br /> .:,t : GavL� /:E ii� %%�•�1 / �Y.' ,� /L,; <br /> r <br /> .:�fi ,{ r .� i r�y � ��;. Aadress <br /> � , , . _ <br /> '�'4!�u(r t i �PCC aca'�i�.>>i �rj�� f� � �� � S <br /> '��'�a%C-��p�. �u jr �„� ielephone Numbcr <br /> `/ <br /> :- , � r,�. , <br /> �_ , <br /> � r- � ;. <br /> �-"�'�'�� Dofe <br /> ,., ,�.� -�" . "�).—_�.,<i.�.;_.. `'�,� . <br /> �, •. <br /> Inspectw�s S�gnaturc i $ �y . °'jQ L l0� <br /> Fee <br /> Dale ---- <br /> DEPT. APPFOVALS <br /> Remarks �� En�inccrs _ <br /> Waler��1 <br /> Stnacf— <br /> � Communicotions � � � <br /> Traffic_ <br /> __ Planning _ <br /> APPRO!i� � <br /> � /,' <br /> .��C��-�Q�, �� �, �- C�' � , l <br /> n.v .:�_ _ - <br />