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,,, <br />cn <br />�ffl <br />e <br />�� <br />c' <br />— =�RP <br />The undenigned owner hereby agrees to hold a�d save harmless Ihe City of <br />Everalf from any and all claims for damages thal may arise because of the <br />installafion and mainlenance of the improvement hereto applied ior and <br />further agrees to remove same upon notice from the City and lo replace all <br />publit property damaged Ihereby. <br />Inspecfor's Signature <br />. <br />(N�'- SC�tLT ) <br />3�i'�. <br />R'a ti,...�.�_ �r <br />, t L� <br />.�,� c",�c,� � -i3- �r <br />o�. <br />Call Engineering Depl. 259�8803 <br />24 Hours before <br />construction is started. <br />�` <br />' ?RUViUE FOR <br />'PRO�ER DRAINAG[ <br />� <br />� <br />Variance Required <br />Yes... _......... _............ <br />No _ _.. _... _ .... _......... <br />y.i0/n/I'C`-�iC �Q�£/��/nS � <br />:li,,.��� , i r,,.�%,-�� <br />�-i��a���e a� APPlicant / <br />'1?0 � %'i,.':7 L�-a a b /�A/j'l�S�/�� <br />Addrass � <br />�_J�G'- �i % � .. <br />Telephone Number <br />_ �� <br />Dafe <br />S „J , <br />wnror <br />Slreef, <br />Traffic -�` � - <br />Planning _� <br />Fee <br />�,a <br />' fVOTE <br />CHECK WITH WATER <br />DEPT. FOF WATER LINE <br />LOCATIONS BEFORE EXCAVATION , <br />�- <br />