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The Undersigned L� ^� I% � S� �'�� � �, �� � �� �r" ' ' Daic Approved <br />Hereby applies for permission to C o rJs ��. • /� '� � W��E [j t2.,� 1,i� �-t i/�� <br />At the following localion �� � � M�� ���TC o "� �-\) l� <br />�_ <br />SKETCH <br />IWork to be donel <br />� <br />� <br />S-rr�w€c• -r <br />R79 rpA r rJ <br />_ � <br />� <br />� <br />Mv�� �T�o <br />� <br />� <br />_ � <br />The undersigned owner hereby agrees lo hold and save harmless the Cily of <br />Evcrell fram any and all claims for damages Ihaf may arisc beca�se of the <br />instollation and maintenance of the improvemenl hereto applied (or and <br />{urther agrees b remo�c same upon nolice from the Ci1y and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />— 2s� <br />+I" LIP <br />i <br />�.30 �' '.�.'3—_'1 <br />Inspecfor's Signalure <br />SITE �'[i�CiCLL� �—ll'-7� <br />Dafe <br />;:�II [ngineerin� DepL 2�9 �-�� B� <br />24 Nours be(ore <br />construr,tionf '" started. <br />1 <br />�_,s <br />, iVU�iE <br />Cli[CI< WITH WATER <br />DLPT. FOR VJAT[R LINE <br />L�CA?IONS BFFORE EXCAVA1106 <br />% <br />ri `,�'1;-y <br />_. ..: �. <br />�LV� <br />_ ` <br />� �� '�� <br />` —. � <br />��� � <br />O� � <br />�_ Pr�1 V '•r <br />U NP4, <br />Variance Requireti <br />Yes..... ..._ _. _... _ _..... <br />No.....____.__._._.. . <br />� �iyQ n D�� � �.I� r�Lv�G�^� <br />Signafure o/ Applicant <br />7�31 4�+h (�„e w <br />Address <br />�S5 ���s'3 <br />ielephone Number <br />'� ��S'j79 <br />� Dale �/� � 7v <br />a 12 .5°� �� <br />v <br />f ; <br />���G 0 �� 2� -i-74 Fee <br />DEPT. APPROVAlS <br />Engineers ' 'I< � .� r�o'� t •:1 % � s �7 . <br />Water /i�''"-„� <br />_ Strcel_� ��'^'��. _ '`" <br />Communicolionsy�' �� - - — <br />Tmf(ic _.�•c�� .2 /_j %4; <br />_ Planning _ � � <br />;;;`� - FOR <br />�,...__ <br />� PROPEi; ORAINA'.�E <br />� <br />i <br />.. \ <br />�_ , .� ,... — t <br />� ,.�:o .�.. <br />