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; -..; �- . <br />'-_-, ,./✓ �__.�r_ f..:'. <br />The Undersigned __. _ _ <br />Hereby applies for permissior to - ���'�-�'' "` �.��✓C.% � __ _ <br />At the following locafion ���/'> �/�iL�� /�� �.�Gt/L'� _ <br />SKETCH <br />(Work to be dorel <br />The undersigned owner hereby ac�rces to hold and sovc harmless the Cit� uf <br />EvereH from any ond all cl�;.ns for damages ihot moy a�ise because af the <br />insfollation und maintenancc o( Ihe improvement hereto applied for ond <br />furiher agrees to remove some upon nolice from ihe City and to replace oll <br />public properly damoged �hereby. <br />��� IY�/� `� �. <br />� i/ <br />�.1 , <br /><<.; , <br />,. �J . <br />i� <br />_-��q� �i-� /'� <br />.'�.�f�i���a`-��Y ���6-�c.4iiLG.� <br />Inspcclor�ignafure <br />/l'�� � c-'� <br />� Y. i,�J Ij �r.. <br />( <br />,��� �' �� � � � . .. <br />Oci-bber'zS, ;g�4 <br />Date Approved <br />Variance Required <br />Ycs . _ _ .. _..._ __.. <br />No.. .. . . . . .. <br />Signature a( Applicanf <br />— Address <br />Telephone Number <br />Dale <br />� <br />Fee <br />/� DEPT. APPROVALS <br />Enginecrs �i-vr/"�^-u„4 V �l--�T�-�'i-+�- <br />Wnter_��. • ` %g`"e-- -- <br />Streef —_.. <br />„�� y ,�,. <br />Communicalions.�'�'�=Uj,� ��i��� <br />Plonning <br />