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c✓ERETT, SVn�H. ,,.crc:: r <br /> Fi-"dr:URf?� /T?%cJ' <br /> The Undersigned_ �^� (�% �� �-- �l� j='- Dote Approved <br /> H�reby applies for permission to ^^>i'== r Q ��-� L' �J <br />� At the following locaticn_ 2yC L—_�� `�7. — <br />�r <br /> I <br /> SKEiCH i � <br /> fWork to be doi�el � <br /> � �i <br /> I I <br /> � 1 <br /> � 40 I 9 ' f� I7 <br /> �---t � , <br /> � 2QC9 I � � � <br /> � _J I <br /> I � I <br /> f � � <br /> v � �g��J 1 <br /> — --� —f I __' -- ._ _ . .__ _ _ . . . _ . . _ _ _ _ _ .. .. -�..-._. . -.. � �_ <br /> —. — __ '—�r:.�s-"�� _—__—_. ___ —.--__ ..__ . . __ <br /> 5 -rN , ST. <br /> The undersigned owner hereby ogreer �o hold and save hr.rmles; thc City of Varianre Rr:quired <br /> Everclt from any and all daims for dcmages that moy ar.se because of the Yes . _ _. ..__.. ._.._. <br /> installation and mainfenance of Ihe improvemenl herelo cpplied for and No ._ _ _... __._._ <br /> further agrees to remove same upcn nolice frorti the City and lo replace all <br /> public property damaged thereby. <br /> �,, � , �. <br /> �i >,c �.% :�1J�,4.f.- �r kl�cC�h�cn�r.�" <br /> Signafure of Applicant <br /> s <br /> Y{'i' i �� (J {;�i�•`/ �f' :i `.� �f-�. l_1..L V UC. <br /> '° - � Address <br /> � � 5 � <br /> E ;.: c_� <br /> „ Telephone PJumber <br /> 9-�� - %� <br /> Dafe <br /> ;,., ' -7 <br /> Inspecfo�'s Signafure �✓' � � '�'�7.�".- � `Z�/D' / � <br /> );/�•.- <br /> � Fec <br /> � /T G%i/t"C.r:D ��ti��7� I <br /> Dale <br /> DEPT, APPROYALS, <br /> Remorks Engineers, _ <br /> � .�/��.,C�� 9/ti�/�� ; <br /> Water ) ' __ �`/_' � �:, , <br /> Street —._.. ..__.... .._.____. . - . . � <br /> Communim'ions �� �������-1P��-'-�--� <br /> Traffic �"•r'l....�.:: �4/,-.!-;/ . <br /> Planning �`1y� I <br /> , . . �. '. � �. . . . � ; � . <br /> ,'�i I � �. L_lufi! ,. . � :_ I �- �.� . � � . , , <br /> �L: � � <br /> ii;.siruction is startr.d. ����. ' ` ' ;� <br /> i I P?tUi,t-. n, , �_�.�. <br /> F� '��-,r�l <br /> _ 1 <br /> � <br />