HomeMy WebLinkAbout30-Day Temporary Power Release05-07-' 20 09:38 FROM- 7728787656 T-850 P0001 /0001 F-019
r ais nlpion
a ' , ve
'er F0: 02 .
i � Fax-T72L4G1-W 3
MY'.�! '
Date: . Q Permit Number N.,
Proms Addrem
THE UMERSIGNED HE`it,EBY REQUEST RELEASE QF ELECrRjcA.L POWER TO THE ABOVE, DESC MED
PROPERTY, FOR A PERIOD NOT.TO Exast). TmRTY ;(30 DAYS, FOR THE PURPOSE OF-TE.SI*G SYSTEMS
M') EQLUPMENT IN PREPAR QN.FOR iA FINAL INSPE N. 'IN CONS08PAMON OF ApPRov& OF THE
PaQues T. WE. H Y ACP OV �E AND A64KEE AS FOLLOWS:
1. This tw"rary power reJdase is- seguested f.br-the above sad Apse oly, and Uwe WE be no
0=pancy of any type, pftr than that permitted by coiisixuction during this lime period.
2. A witrte$s by our signatures, We herby, agr'.ee tb abide 4y Ali terms and aorf ditions of this agns~meriiy
inclu.ci tg Building DiViftn Ploiicy, w,bizh is Fnmrpotated herein lay referwm
3. Ali c ondition"nd requff'Mer ts.bl-d in the ati'aahed d=merlt erfted "Requirements fbr 30 Day
Power for T.esiingp Mime been fuifilied-and the prernlse is ready for compiiance,inspec[ion.
.4. All requests liar an extension b'eyorid 30 -days •must ire.. made in wdit too the
e Building Oi�ai stating
Ulu €or the request Power maybe removed from the site.and/Or a Stop Work.Order issued if
the Finer 1nspeWon has riot beers approved whin 30'days. A fee of $100.0b will be required to in
the Stop Work order.
aNE HERBY REL E AND AGi E T0 HQLD HARMLEgs, sr .LU,m COUNTY, AND THM EMPLOYEES FROM
ALL L BFF:I M AND CLAIMS OF ANY TY F. OF NA -PURE Vt HjCH MAy ARISE NOW OR T�t THEFUTURE OUT
OF THE Tt i VSAcmk INCLUMMS ANY T Ai K(�It`fil M ►Y SE' INCURR€ ptlE TE3 TH
DISCOWC-ChON OF ELEC-ICAL POWER IN THE°,EVEW OF VIOLMON OF TMS AGRaMa