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At the following lomti,n -.1� L-'� l �% �� �^r — <br /> SKETCH <br /> IWork to be donel <br /> -t i I� � � <br /> �/ � t. J <br /> GT �� <br /> ..A <br /> ��� \ _ � � ^ ..i 1 . � ,... � � - � <br /> v 1i .�i J� r.— � . ., :_�* ; u L%;:=' _ - . <br /> s � ' <br /> �� ' � <br /> ^^ '��_'_ �, .r� . . . ; � /.'. ' ' . <br /> — r 7 �� <br /> .� .� . � =�1�01 <br /> ' '...—_T...._ �::,._"_"_' __ D' <br /> � <br /> �_ 1,`. <br /> ��`i�.' I `t:. \�. <br /> � ��I�CI< W;TH VdATER <br /> ..'-f'T. FC:^ 1'IA��.; Up.�r <br /> �, . y.�� �. . � , - ._. ��- �r. <br /> I�,L�, C..� t �.' ', �_ �, ,°.l'L._._ <br /> The undersigned owncr hereby agrce; lo hold and savc harmless Ihc City of Variance Required <br /> Everelt (rom any and all daims for damages t5of may arisc because of ihc Yes. ._. . . . _. .. <br /> iostallation ond maintenance of the improvement hereto applied for and No <br /> furlher agrees lo remove same upon noKce from ihe City and lo replace all � �- -��-� <br /> public properly domaged Ihereby. <br /> i- ;. <br /> �"' i,' <br /> -j.� � ; �.�����_ <br /> ' , i1� <br /> C`� ' Si�gnalure ol Applimnf <br /> ?r� / �' <br /> �:� �� t:;- , :� �.. ��i ��, <br /> Address <br /> �� � ` 2 — C/`� / ,f <br /> � � ielephone Number <br /> � <br /> � Dale <br /> �,%;�.,l:i�� l�.�,,.„ . <br /> InspeUor's Signafure w j��a!1� �_— ', ��� '-' <br /> �� �� i - i ' , % Fce <br /> :�;' r� _ '�, <br /> ��r� ' ' <br /> DEPT. APPROVALS <br /> / J <br /> Rema�ks Engineer r t�- <br /> Water — <br /> Slrecl <br /> Communicotians �•� � !� � - �,L.�����— <br /> T�affic <br /> _ Planninc� <br /> �� �, . <br />