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- -- - -- - - <br /> t the fodowing lowtion i _ - : <br /> 1 ETCH <br /> ork to be donel <br /> I = <br /> `—-- •------� _ <br /> ---L ANE , , r',::� � =__ <br /> --- , .�. � _--� <br /> � �-; 1 <br /> , <br /> � i Lc��i/.:�, t �_ , <br /> I � ! � � �.. .p i . . . . <br /> 11 1 � ���}i5�/�� ••I :/ �A�L..�%•Ll�.i <br /> I A <br /> /�_) '{�� <br /> `` ,``� I II-��- <br /> -- � �� <br /> � � -' �"�I <br /> � <br /> ,� , <br /> ,! � ',%` Z �1 <br /> � ,I � <br /> � � - - �---- <br /> _ �. <br /> -___-- <br /> - <br /> ,.L. _._--..-L__.__._--- <br /> ��l��/�.�JL;'�; �:/V�i�� /� 1��. <br /> ondersipned owner hereby agrces to hold and sove harmless the City o( <br /> tt from any and all cloims for damoges fhof may orise bewuse of the Voriance Required <br /> lotion and maiNenance of the improvemenl hereto applied !or aad Yes.. _._. ._.. _ __.. <br /> r ogrees to remove same upan notce from the City and to rep;ace all , � No . ._ ..... ._.. <br /> c property damaged thereby. .,., ���-�� <br /> � r, <br /> 1 <br /> : ,' ` �i-'' c � . . <br /> .' Signafurc�ol Applicanl . <br /> ., � � - ".� � / � <br /> Address, <br /> . . � ��.. .�� <br /> _ � <br /> .. Telephone Nunrber <br /> �—:�� / <br /> �1'f�'G� G � _ �Lt.f�Z:{.e�� Dafe <br /> ior's Sign ure ��'— <br /> i <br /> ,%" � <br /> � � / �y — <br /> Fce <br /> _ DEPT. APPROVALS <br /> � � ��; (� <br /> Enginecrs L�'..�...�' � �_r�S�-�,,.� <br /> Watcr � � <br /> Slreet �����-�-t!� <br /> Communicotions � �i ' ���I -� <br /> TmHic - <br /> Planning <br /> \ <br /> J � / <br /> V <br />