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� .� �.,,..,a. >J `�i_.�.`�c�1�� �r.] � Dole Approved <br /> The Undersigned j`�`�'-�-. — <br /> (, _. <br /> Hereby app�ies for permission to ��[•`, r�'.3:� _ i-I���` l�l �V��lz���_�-, � ':_ '..'/-1 i'�_� i_" �; -�� <br /> }� \ ,�\'"'�`� RI ;n1-t.�. : tJ=,�-� - <br /> At the following bcation_ ' � 3 � � "� �Tl :: ry �'`-� <br /> SKETCH -r�cu r,iL �-F- . �I <br /> IWork to be donel m �t` ✓ 1 ,._;ts-rh'�p.,,, � �I <br /> � � <br /> � j in <br /> � o I �` <br /> � I <br /> 1J:> � m <br /> � -,C''�1-e � � -f,ql�les Yo Se 1.ZEP-io�%CC` <br /> � ��n �{�n ' <br /> �` GAt - W" . _ _.c/, _� �. _ _.._. . _ __—___ . -_ <br /> � �� � �� '� <br /> 1 <br /> I��../ �I,�" � � _ ._._ _. _- ,_ _ �- -� <br /> I„ y (�I �EY,sT of�� <br /> , b `li' �� <br /> �� ; <br /> / „ � '��� �./i • � _ -- . - E'✓i_ !� �-;�-_- '�v C _ <br /> i� 1 , , (� rU� � <br /> r I' �� <br /> I` `� � ;�� �� ��� <br /> � � � <br /> � � ��s �,� _ ���, <br /> �s � -- --- —� , ------- - - - <br /> 1� 1 'I <br /> The undersigned awner hereby agrees lo hold and save hormless the Cily of Variancc Required <br /> Everell irom any and all daims ior damages ihat may arise bemusc of ihe Ycs .. . . . .. <br /> installalion and maintenance o! the improvement hereto applied (or and No . . . . . .� . <br /> further agrees io remove same upon notice from the City and to replace oll <br /> public property domaged thereSy. -- <br /> � DRIVEWAY SECTJON�� <br /> NO SCAj.E�� — <br /> �� � $ignclure o( Applicanl <br /> „ �iP , 9r� uoRrl� �4��s>. s�rrn�/4�i3s <br /> 30" -- 30 .. <br /> ndd.e,: <br /> j' ��\` Telephone Number <br /> �. � M - U — S/7:�r9 <br /> \, Dale <br /> Inspeclor's Signofure S 2�0 ��� <br /> � Fee <br /> }?�_; .':. :5�� �-Y�i: <br /> Dafe .,J ' .7. r..,-�/_', <br /> DEPT. APPROVALS <br /> Remarks Enginecrs <br /> _3 _ � <br /> Water "�� ' � — � ' <br /> $Ircel �''. �' ��"� .c i�' �' S <br /> CommunicationsL. '1�.�, ,: i;�,��. - - - <br /> Trof(ic�- � f�� `�l = - <br /> Planning,' - � 1 - Z G ��%3 <br /> � . <br /> ��u�aut's C.� ' ';�; -1,t;i" . UliAli`ii�� <br /> 24 Nours befare � �� ` " <br /> � °°,��ed. cFi�a< v.�ii� ve�„�.��� <br /> UEPT. FOR �lJA'f[i: LiP;E <br /> " ^�1P.- . . � . ,� � '���.':TIC��. �.�.......+:,,.-..-.e.»,.,-._-._�_.- <br /> ..�.�. <br />