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G'� <br />0 <br />The undersigned ownen c�reby apr�es to hold and save hormless �hc Cily of <br />Everetl from any ond oll cia'm, f�r damages Ihal may arisc bewusc o( Ihc <br />inslollalion and r..aintennnce of ihe improvement hereto applied for and <br />further c��e•¢a ro remove some upan notice irom ihe Cily and to repluce all <br />public property domaged iFereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />{� �' S -I <br />��_I•1�_LIP � <br />� 3� ►�j� � 2�� --�30�� <br />,- � ti f , � 7 � � � 3 -, <br />Inspeclor's Signafure � � v/1� - <br />� ('/ <br />�� ii /-' C.v.� Cr� t�J %/-,.": i-7,� <br />Dafe <br />CNEcl� Loci7raonr oF �f✓A�T�t� 56RvrCE <br />Remarks <br />T-n ��zo pr_k�TY �� i T� s //V S Tf2LLl�l� <br />� <br />, .(., ..,_ � . � <br />rRUPGR L'i'riHiiin�s� <br />_ /\ <br />�:v�E <br />i'HfCK WITH WATER <br />GENT. FOR V/ATER LINE <br />�_r�;�Ttl,l�•d5 BfF�RE r�r,rqV;�Tt[a'� <br />� ' <br />27 <br />Variance Required <br />Yes.___...____ __..... <br />No.._ ........__ .__.... <br />--� � _ %' 7 �--� <br />� ,:� r , � ; <br />—� � „-.-� <br />.' Signafwefal Applicanf!`� � �/'-�' <br />,/ , �i <br />��. �, `s';X � �/�/ <br />LY/VNG�'('G+-� Addresz G,.-�-7'::.,I�. `jC�- _"--L-, <br />��'% `_: - � ��f (�- <br />Telephone Num6er <br />Dale �!1/:^ i ,7 - -� ._ ; a-,r <br />S ,�L, vU`� �� <br />. �C <br />� Feo f )� <br />� z C. I� f�: j✓�,�`. <br />DEP/T. APPRQ/VALS ; <br />Engincers-�� CC:-.�� �[C�.�'%" fi'...''y�'%'.' <br />Walcr � � � �u. - 2/- �- <br />x5treet ��,-� �" s,--= � <br />Communicalions_�,` %-=- �- _- � ��'-- -- - <br />Tmf(ic �. ->%'/. � //- 20 - �7-:.. <br />� , � ' ' � <br />Plnnninl3�--":�. /�—� � 1/ <br />.,.,�. _ _ :.:�III� �ii�Y <br />2� Nours beir���� <br />i.DfIStWC�100 iS Sf�� <br />.P��..�. <br />