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L <br />` NqTi E <br />� � -r_K <br />Thc UnU��siyneci _ <br />liereby applies for permission <br />At the following local <br />r• _ . <br />% t /•a- �- t , r, i , <br />_.'_Ga'e :,ppiovc.'.. . _ .._. <br />The undersignnd owner hereby ogrees to hold and save harmless the City of <br />Evcrell from ony and all daims far domages thol may arise bewusc of ihe <br />instollalion aiid main�enance of the improvemenf herelo applied for ond <br />(urlher agree; ro remove same upon notice irom the City ond to reploce all <br />public property damaged thereby. <br />i � �f,'IV�\JF,Y_SECTICN :..' <br />� ''�-- ..._ 4� ��r,;i <br />I �1'._ _ � ., .. <br />j, �_._1.__9. _-__ �_ �.�-= wA - <br />.�e�_.�._> > __� , <br />� _._.__. <br />PROVIDE FOR <br />f=RO?ER DRAINFlGE <br />Variance Required <br />Yes ._ . _ .._ . ._.. <br />No.. .. .. . ..... <br />- '�`Y-- <br />E��.'-. N � <br />� _.__ _ �7 , -;� ; - � , � <br />_ y ... . _ _'_ ':a�:./-��, � '1C: /_>c�['�l.tY <br />(Ni) "=5c. alt� <br />�(dJ-3 � n �,,. � .�,- �� Telephone Num6er <br />-- ���,"�•� � �/- '1 S'- %C�: <br />Inspector'> Signalure <br />�SiT� �HC�C:�c�u�� P�� /�G> <br />Dale <br />,.� <br />Dale <br />. � , <br />` � .�.-,_: -- � j <br />r�: s S y" i C �i <br />��R t 1 ' l,,- Q ` ' <br />- �..""'L�� w.,,�,�_...+... U ' Fee � .. � <br />- �� �� <br />_ i,,_. +@a;,��; i. <br />'I <br />-�-�-__....__�-.�......... _..----.,...�w._»— ) <br />DEPT. APPROVALS <br />Woter <br />Sfrect, <br />Traffic <br />Planning `��"� <br />D <br />