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/ <br />The Undersigned �`� / �������f �� �J — <br />Hereb� applies for permission to �-, ' F; '�� � <br />Af the following <br />SKETCH <br />IWork to be donel <br />\ <br />-% . 1 ',•/� <br />J` , ,".',' l/� <br />, � <br />_ �; �2 •�� �� ; /• ,, . . <br />.. J : _ . � . --- � ._. <br />� <br />�''c.�,o�.r a - ;> ` - e , _r'.� �. :�:: <br />- � <br />�----- --_ _ _ <br />; v �A� n. .�: ;_; _' � •.� ,Y�. <br />J; <br />----- -�E/VV1�l_k�:� <br />f � <br />� . <br />� I <br />I rJ <br />I�G, <br />/ <br />�a i <br />�.Z2�'l S2I IZ2� <br />I <br />� ..._,.Y._..._...._._...._.._.-_.._..._.._ ____.. . __ ...._. ...,.Y....�._._. <br />�- ,°/.•-.-- _ <br />Thc undcrsigned owncr hereby ogrecs to hold and savc F.ormless Ihe City � <br />Everell from any and all claims for domages Ihat moy arise because o! Ihe <br />installalion and moinlenance of the improvement herero upplied for and <br />luriher ogrces lo remove same upon nolice Irom Ihe City ond to replace oll <br />public proper�y damaged �hcreby. <br />ti,E'/ :/E <br />, <br />� <br />Dale Approved <br />./t��1''...... '_ <br />�i^ -----r--.- . <br />�/..:-- __�,_ _ - - � <br />Varioncc Required <br />Ycs _ . _ .. .._. <br />No. . .. ... _.. <br />NJ.°j:`U.r //i",4.�N /',�,'-•r" �iNU.�„ <br />O/,'I:'r.: wy)-.r .— <br />_/ r-} - <br />t x .-,__�_ . '��• ��_f <br />In�peclor's 6ignalure , <br />Dale <br />, ��� � �f � <br />.t,� w'7��'�J�'/�.� .%'T <br />� . � � Signafure o1 Appliconf <br />�- <br />✓, `, ��.. � �� i i(I <br />' / R�! <br />Address � <br />,� ;� -� —_��J�;-� <br />� ielephone ' �ber <br />� -+ `., _ .} <br />Dale <br />a L- r�: � � a <br />Fee <br />DEPT. APPROVALS <br />� <br />Enginecn <br />Water � -- <br />Slrcet <br />Communicalio si � �` <br />Tra(fit i <br />Plann�n�. --.- . <br />