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y �_ � //�N�' 30�—/y7D <br /> ✓� L� L��� Q�\/ Dale ApprovEd <br /> The Undersigned F <br /> __ : .� .-l. / z '' ��, .� / .^ � -' ." /-r <br /> Hereby applies for permission to <br /> At fhe following location ��� � � � / �,��'� �� ��� '� <br /> � .IIRIVEIJAY . SEG"f10,7 � <br /> SKETCH � ----•----�{ <br /> IWork to e donel � /� ° <br /> � ��o�-----_ <br /> Mi <br /> --�-i:_" ��/R <br /> "'� n �-- "':.��_. �' <br /> �1 I I v <br /> � _ 0:=3oole.-: ._. <br /> � 12 <br /> 'I ' 13 �..�4.0" <br /> ll I __ 061][.EW.hY �GC7 fON <br /> � N (r,ra - scA�E) <br /> � � 14 <br /> � co��c. o�r� �;� ✓,�,� �� '��. <br /> � � p . / � �� �� � �~� �.. .,�__ �O <br /> '^' ?oi �AR p 15 -' { `T_�__y!"41_P__�.__._ ',' <br /> , � Po�r �`� �� . _ �J t . _,�-- /z, <br /> ��_- - <br /> , � 4 ' ,.1 <br /> �.�' is � �- <br /> s <br /> / 7 T" ` A l�E�I�UE <br /> The undersigned owne� hereby agrees to hold and zave harmless thc City of Voriance Reqvired <br /> EvercR from any and oll daims for damages thaf may arise 6ecause of Ihe Yes.._..._._...._.._._.... <br /> installalion and maintenance of fhe improvement herelu applied for and No_..__.__............... <br /> iurther agrees to remove same upon notice from the Cily and to replace all <br /> public properly damaged Ihereby. � <br /> � � t��/C /�/ <br /> ����lu�(i. �/: -/- <br /> � /" J�' , �r I�(,i,"-°- "�`-c""-' <br /> , / ^7L' / � ,GOZIwt� "! � <br /> 7_� �,,(L.�,.�,{. /�-�T� � .1 ,�,$jgnoWre of A tanf <br /> , G IS�S ��..��+' <br /> j�—iee_^c _'��—...rt-��'�. � .�� � .'��' X/ L� 'Clc>ic.ti�� <br /> � Addrezs c4�zO <br /> '���_ C_ �y�/ <br /> ,�;�� . ^ Telephone Number <br /> �. ��.t <br /> ,1 t � J c� — �YJ�� <br /> K <br /> Dale <br /> Inspecfor's Signafure b !O �--v Q)^ '182� <br /> Fee <br /> 'S"i rF C.S�.rC�E�� ���o <br /> Dafe <br /> DEPT. APPP,OVALS <br /> ��.�1���%�n�v <br /> Remarks <br /> Enginecrs u� <br /> Walcr "'"*" �' = � <br /> Strect J� <br /> -,� , , <br /> Communicolions -' � ' " " �- <br /> Tra(fic <br /> Planning <br />