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SKETC , � I Q�� � <br /> IWork To be ne) y _\ j <br /> � � � � <br /> Q, �,,; 37 x3 39 4O I 2 3 `� 5 � 1, <br /> ;� � � <br /> d � <br /> � � ;E � � <br /> 1 � �:�/r .p�% ra ,sE ►� <br /> � R GGCA TED T o �/'✓cP, � <br /> E f'-FP✓ �F O <br /> � � <br /> .. ed� • 2d' � <br /> — � ��a - - -- - -' --- -� <br /> � — - - ' - - '- - - � - - .o•e4 --� �' _ <br /> G iGflriti�G Co�c�oUi7" � •• �c. coniC. l�RiVEWAY <br /> .�/ L Vti / T- 7- �1 V Eti�U C- <br /> The undersigned owner hereby agrees lo hold and save harmless Ihe City of Variance Required <br /> EvereM from any and all claims (or damages thaf may arise bemuse of the Yes._..............._........ � <br /> installation and mainlenance of 1he improvement hereto applied for and No_.... <br /> ._.._..__.__.... <br /> furfher agrees to remove same upon notice from the City and to replace all <br /> public property damaged thereby. <br /> Nor�'; Po% 1'� 6e r'�ia� �fe�� �3' eorf cf 1ayE� �MS�-- ING, <br /> �r�°-f�i)f �G�qf"iOrY, �i�7t� C��7 f�, r.. aF Signafure_ _oFAppycanl <br /> �'o/e 2 y ' ��oni �a t P o { c�.....6 +��s� rf��w�r r <br /> � �S 2 � .�EVCR��� f3Lvc�, <br /> EX�J�iii9 �o% u�s�i.�fci .�/: �'a r 3 J�-'�� �t/r.',c�h,:/r�JT��S/ 9B2a/ <br /> /'�-<ise, f�f%°%�o.�f u�;// �.>sl�q// 3S3 6427 <br /> ��6<Yi�f�PGI� q�/n7/�)Uit1 �'�ti /e� TelephoneNumber <br /> ���/��t�C _'L-72-"!L7 <br /> Date <br /> ° � n Z Z <br /> ���p«�a, si8nof��. s '�/C,' — %v. �1 -3 /� <br /> S� G��,eE� y/,��ia F� <br /> nafe , <br /> �� � J� � � �� � Pi. APPROVALS <br /> ��./7- IC"� �.0 �I��C i /��^'.:� " �' .- ' �' ' c� � <br /> arks ' Engineers � . "`"^^"'� �/1d�7v <br /> Water ��� "� � ' <br /> Street �^ <br /> �}S-Communicalions � �r - � - G�� 1 <br /> Traffit — <br /> Planning ���f. <br /> � <br /> '�f. ���+'�� �: .-� , 7`�� �-c�.�J:i�-� /+�_.F,. <br /> .. ; i <br /> � . , r . . • :J�7 S .'�,S <br /> \•� l L <br />