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At the following location <br />SKETCH <br />IWork to be donel <br />_...��.r .r ..� <br />� ._—, <br />!.-. 1':��';��, � i�'•_"�' .� ' <br />1\ <br />� <br />r+�•r-- <br />: <br />� <br />: <br />. <br />< <br />� x <br />� <br />�� <br />< <br />l <br />`w< <br />I- � i <br />h z; <br />� T' tr�; - ._� �' :i �;%. - x. w . <br />� `� W IL � <br />E r i s T i H:• c-<: ;�/� �, ;; :: <br />< <br />F FNGE..�. �_� iUc'�,:��:."t_''551.�,�.1 ,(���ir.:). i <br />. � .. .- r... .. _�.... . �t' . r .r � �, v w �r v � <br />r;���� ; � w _ . . <br />i . <br />� <br />�",a:�Fo � ; <br />. ,00rqu.ar� <br />- Fo.� � s� ,n <br />,c,��vr., �„E�r:� ,�3�' P,eo ✓ioEv - <br />� �c.�nir, ��._� - --- _---_�,._. _._ <br />� <br />�"�_.zi��t��cr?ry� .P.���R Wo,p/.' PRc%�-�r'r'---__� <br />The undersigned owner hereby aarces to hold and savc harmless thc Cily of <br />Everell irom any and all claims tor damages Ihaf may arise because of Ihe <br />installation and mainlenancc of the improvemenl hcreto opplicd for and <br />furlher agrees to remove same upon notice irom Ihe C:ity and to replace oll <br />public properly dama9ed Ihereby. <br />/V(J/f ' <br />� ,������ ,��.�� ��.� T!-"i�>P!'�F/R'7 <br />l�S,c . J`�/x % Gi ,�/C��'i �/NT/Y�S; <br />�y <br />Inspecfor's Signafure <br />. S�r.� C:y�c,e.cv �/y/rr> <br />Date <br />n <br />7. <br />i� <br />�' <br />o; <br />z; <br />Yes .... . ._ .. . ...... <br />No ...__..�...�_ __.. <br />.� ��/., D <br />/ . <br />�� % � <br />.� X/ �J-. f � . �1 : /ii%.'7' - l .. <br />�Signalure ol Appliconl <br />l 3�, � �-`n rz. � o ti� <br />Addrezs <br />��- `�_. >/ jr % <br />Telephone Number <br />� <br />��; .;.. i�i.� � � _ /;v � �� <br />. .):..:.� — �i� <br />Dafe <br />5 � /-'ac. <br />Fce <br />DEPT. APPROV LS <br />�' j J <br />Engincc � �� � �'��/�U <br />Walcr � ' � =` <br />Street —�1 .Cf. .� , � ru�.:. ��4�.y � )i � L_ <br />Communimtions ����-''�• ' � • <br />Tra(fic � Sc^e i1•�^nio 9 /d..lo <br />Planning ,� � � <br />:r - , -1- .� �'-J�-.i <br />c i�<r � :... /.jr .�i: J�:.:�,•_ , <br />_ r ( y= <br />�/- . . . <br />'"' r i*t c s�t c — <br />�L <br />