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The <br />Hereby applies for permission <br />At the following location <br />SKETCH <br />(Work to be donel <br />_. _. , ,�.' .- <br />� <br />/v[r <br />�ii=?�' i D%�J <br />� . ,. <br />� Dote Approved <br />� � /�� ` <br />S�'r� ;.; ,. ,--.a�✓ � zo. - r o �s f" 1 <br />LG-i�-C%/�/<= ,•'_f?/,!r� <br />The undersigned owner hereby agrecs to hold and save harmless �hc Cily of <br />Evereft lrom any and all claims for damoges Ihat may arise because of Ihe <br />inzlallation ond moinlenancc of thc improvemenl hereto applied for and <br />Iurther agrees to remove same upon nolice (rom Ihe Cily and lo replace all <br />public properly damaged Ihereby. <br />DRIVEWAY SEC710N <br />NO SCALE <br />f.--- Z t ' ----i <br />�I" LIP <br />— _� <br />r30'�f� ii' „�.30��,� <br />'i <br />�. <br />. _ �,. � �c.,...- . � � _ ..� 1.�. , . . . <br />ln:pecror's Signafure � � <br />_� � �. . . . . _ L /,�'��� <br />[/ <br />Dafe <br />� ��_,��/', <br />� °f . <br />Variancc Rcquired <br />Yes........... _. _. . . _ _. <br />No.__.__.___..._ .. <br />/ <br />� . . .. <br />- "t_.ri:./ �_ �.;, c /� %�. <br />_i { i.�; Signalure ol Applicanl <br />.., <br />, <br />�s,� �_-. .--, :.<���.�_.-� � , .�� <br />Address <br />� - _ <_ " - , <br />ielephone Number <br />� <br />,. . ' , ' <br />Dale 7 <br />S �v���l.; L��/C�/ �/�Z'i j3 <br />/'. �/�' C, <br />i Fee - - <br />i� 1 �/ i i � <br />� <br />. , t ' . � <br />DEPT. APPROVALS <br />' , <br />Enginceii . ` '•" '. � l� `�`�" �� " - <br />Watcr ��l aa`. c<..�s, H"-1 � -% <br />Streei'� `�{ �•� L-. /•:,.-- !. , <br />, —� <br />Communicaho i��� `��`—���^ .`. <br />Tmftic � //_' 4� � ,:;.';�z: <br />eia��t�&> : i �1 � � —73 <br />:;-,� :' J, _ <br />, ., � b�:.fure Ca[CK VJITH 1NATER �1'RVi'Lk� �=��;.�,'�'. .` <br />�u�n: ; �5 StartCd. CcPT. FOR INATER LINE <br />lOC.4TfOt1S BEFORe EXCAVATION I <br />AKO �. <br />