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ere y app ie: ,or per�r.����,on to - ----.�' ---- - — <br /> At t6e foilowing lomtion �� �� �/—' � -� ' � r� `' '' / <br /> _ /( b . - <br /> SKETCH <br /> IWork to be done) <br /> �z <br /> i� <br /> �\ � <br /> , <br /> . ,-.^, <br /> -- -------- - __ - <br /> �.J <br /> .� <br /> � J - � <br /> +N <br /> �/ <br /> -- .o, <br /> _ � / J ----- � `U I"_�-G: <br /> � <br /> � � C'D�V C'�P� TE D;;' l/E � ,�� �. <br /> - -- :`�� <br /> . __ <br /> The undersigned owner hereby agrces to hold and save harmless thc City of Variance Required <br /> Evereu (rom any and all daims fcr damages thal may arise because of the Yes_............... <br /> inslallation and maintenancc of Inc improvemenf hereto applied for and <br /> further ogrees to remove same upon notice from the City and lo replace all No......_.................... <br /> public property damaged Ihereby. <br /> _� i <br /> �j-� '--c��-1����-- <br /> ,� c„ . <br /> � � �,f''- <br /> ,: � 1�i% ,% , <br /> :i ��" <<.G� Gt4 <br /> � Signalure o(�ApplimrN� <br /> %:�,�/;% ?� .,Z_`i.�J�"': c. r <br /> A�ldress �� ; <br /> .�/lc��i��iv.,i i . __ <br /> -C `, 2 — — "� <br /> iefephone�Number <br /> / ��• (�� / Dafe <br /> .�. �`1"rL l__ Y�7�—�.�rH....rg / / W f �.. ,.� <br /> 'Inspeclor's.'$ignafure / $ F— —"(� �r' r r, ; y� <br /> �O� 3�9 Fee <br /> D� <br /> DF.PT. APPROVALS <br /> Remarks . � � <br /> Engineers <br /> Waler � <br /> 5!reef <br /> Communications -t --��'-^ -/�- ��' <br /> Traffic <br /> -- Planning — -� <br /> \ _ <br />