Laserfiche WebLink
° � ,,: <br />�_�,2 � -f., . . - ; <br />Ai fhe iollowing :cmfion l __'..:..L�._.' ; • '' r "- _ — <br />--�.__—..._____-_,..____.�_-_� -...�_.._.,......._.,_. <br />---- ------- <br />SKETCH � �" --'� <br />IWork Io F,e donel <br />� <br />� _ � <br />.J _J <br />, �__'_'"' <br />j� <br />ra ' <br />G�'��et��'' • <br />iJ=:p�./f9L% C-��',';�':— = <br />r .__ . / <br />� <br />�� � /� � ,.. <br />�,[ /...-t,-/' G(.,A�.-� <br />._1.� ! � G i��i Z (A-'I � . <br />The undersigned ovmcn c�reby agrces ro hold ond sovc harmlesx thc City o( <br />[vercll Ircm any and ull cloims for damages that moy orise bemuse of ihe <br />ir�stallalion and maintenance ol �he improvcmcnt hcrcro opplir,d for and <br />(urthcr agrces Ic remo:c same upon nolicc from Ihc City r.r.d fo replar,c all <br />pu6lic properry damaged thereby. <br />% � <br />C,(,`2 :'l,� �' l , �/' `r/�� : <br />� ��Z• <br />% . <br />,/ ' -) ' <br />l�jn.-r� � ��r�_r < �-,. <br />Inspeclor'i �Sipna}ure <br />r � <br />i-� �-- , ��; `/ <br />Dafe <br />Remarki <br />J� <br />C, I <br />C� <br />C` <br />Voriancc Requirr.d <br />Yes <br />r�o <br />fi•=;�; <br />Signafure of Applicanf <br />Address <br />iclephone Number <br />Dafc <br />$ _ <br />Fcc <br />DEPT. APPfOVAl.S <br />�( � ` i <br />Enginec�s � ^�. %�r�. � h� t <br />Walqr ( =' � —�" -� -' � "? C � — <br />—..— <br />Slrcel <br />Communimlions_,����.� � -�����:��r7 <br />I: <br />TffI��IC <br />���Ofl'llfl(] _ . <br />' � <br />