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<br /> Hereby applies for permission to ,
<br /> At the following location
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<br /> SKETCH _�
<br /> (Work to be done) �
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<br /> _.i � EX I 5 i I (�t G F�AV�'t�Ci�t ' �--
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<br /> ��; PROVIDE 12 " CULV(=RTS F�OR DRAINAGE-
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<br /> The undersigred ownc; hereby agrces to hold and save harmless Ihe City of Variance Required
<br /> Evereu from any and all daims for damages Ihat may arise bemuse of the Yes. ... . . .. . .._....
<br /> installotion and maintenance of the improvement herelo applied for and No . . . . _..
<br /> furiher agrees to remove same upon notice from the Cily and to replace all
<br /> public properly damaged thereby.
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<br /> . ...._ . �n�Y�wAY . SEC7"lON " :
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<br /> DEPT. APPROVALS
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