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,.�„�Lti;,i110�d flii; Rlli�il ...� �,,,.'�" i;:...-_ i�"�,i,i; � 11G�.� . <br /> �e�crc�; <br /> \� , <br /> � Et;t,v7 N0.__LG=I L- Z _ <br /> ��vtnti f,�VASNIIJ��UN - <br /> Tne Undeuigned_.� � � / <br /> '..-' .,S � � _ — - i/� -- <br /> �' . �;�pPes tor permission to -�-- - ��'�""' <br /> r <br /> .. `ollowing loca[ion_ . --�-�`-- -V-�-��� _�`�-1-�� F�� --- <br /> J- <br /> - -- I -�----------- - ---- i <br /> � � <br /> � I <br /> � <br /> � � ProposPd 1 <br /> � I J-I-U N SG/ ' <br /> � t� I n <br /> I } i <br /> 3 <br /> � � <br /> " � s� ' u <br /> � � � � - <br /> o � � .i <br /> . <br /> � � � , _ - - - -,� � �a,�yl,.� i ` <br /> , , <br /> � � K , ' \ � I 3 <br /> , � <br /> � � ,, , _ _ - _y!� o ' <br /> , <br /> � , � � <br /> i � ' <br /> � _��_ , - <br /> �.f� - f' � ', <br /> _ �/� E'w �� c�� C L� rivC <br /> DHIVEWAY SECiION The undeisigned owner hereby agrees to hold and <br /> NO SCaLE save harmless thc City of Evereit irom any and all <br /> claims for damages thal may arise because of installa� <br /> I � tion and maintenance of the improveme�t hemro <br /> �\` _ 1 f' LIP _ ,pplied tor and further agrees m remove s:+me upon <br /> �-� -- � 1 - -- 30' i notice irom the Ciry and to replace public property <br /> 30 ',_ � <br /> � ' damayed lhere� �, ���� <br /> -�a-u- -'`'� - - <br /> Signature of Applicant <br /> ,ssn.s n c ea,h A''e — - <br /> nddrnss <br /> � �.�jPY OF 1HIS APPUCAilO\ 70 3,5,3- 73i•5 . <br /> � B[ POSTE D ON JOP.SITE Telephone Number <br /> ' CPLI ENGINEERING DEPT.25&8611 _ G—I 3 — 7�. _— <br /> ! ;C HOURS BEPJRE COhSTftVCTinN . <br /> Date <br /> i - _-- -- --- �_��_ . ... _ <br /> - — — - Fc Z=3i:Y_./�,i7 c.�_ <br /> � c'b!FCK I.IST ' � <br /> •.:r vaT.c Dept. Approvals <br /> � I'�� .r,,:ge_ .. � • Engineers � -----.. _ <br /> � C�xb&Gulter <br /> � .^,idewalk — -_ � Water--- -- <br /> ( ��+4'��•.,eti`-_� :Lw=�iT . Street_ -- <br /> / Ccmmumcations <br /> f lispeeror's Signawre Traf lic_ <br /> � Planning --. .- - <br /> � -� , -_ � -- <br /> (late <br /> .��_____. _- __— .— .___ <br /> ', °„�`' 112 5 5 - <br /> � - Approved by <br /> � . li�i•J R n ..,. . , <br />