HomeMy WebLinkAboutpower releaseCOUNTY
F l O N 1 0 A
Planning & Development Setvices
81-111dirtg A Code Regulation Division
2300 Virginia Ave
Fort Pierce, FL 34982
772-462-2165 Fax 772.462-6443
Request for 30-Day Temporary Power Release
e'er m,l Number: - a 1 o a1 - O 109
53 S -v_r ----
-E HEPELSY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE D=S Plar-,
F�`�•'F+��? ���� 4 )E.IOD NOT TO EXCEED THIRTY (30) DAYS, FOR THE PURp65E OF 5-Ir1iG SySrEti►5
IN �REPAQ4TION FOR A FINAL INSPECTION. IN CONSID=RATIO!J �01 Np.k��4 5;.vS ,`S_ l:rt HE;z76v ACKNOWLEDGE AND AGREE AS FOLLOWS:
'`"S .e,ntc•2 �, jr�wer lease is requested for the above statel purpose ortiiy, and the:_ vj ! ;W ,o
Arli yW_ other than that permitted by consriuction during this rime pe-,oc
k w'r' S 2y our Sign?turEs, we hereby a,►ee to abide by all terms and cordrt,ons of ,.n;, X: +•:;:, ,c:-,z S�il�iny- O-vws+on Policy, which is incorporated herein b-r reference.
1" `�'��r;'��� a�� !equrren,en s listed in the attached document entit!ed'PagJazmcn6 f_r .0 `6,
Pzwe- `or 'FSti'K•' have been fulfilled a.nd ian
the prenuse is ready for compice rnsp-ect-on
kl •rquesL for an ertensron beyond 30 dOyS must be made in venting to the &nterny t�rfca' st3; tt,F rcc,<Y, for the reauest. Power may be removed from the site and;,or a Stopfir:
has not t*en approved within 30 days. A fee of $ 100 01) w ' b-2 re.;.-�,re-, •c
►'= iE =?� P!ELEfSE AND AGREE TO HOLD HARMLESS, ST. LUC:IE COUNI`r, .AND THclh cM.:L?yEc_
_,, t_IA-E-ITIES ANLU CLAIMS OF ANY TYPE OF NATURE WHICH F1AV ARISE NOW OR IN TN<
A.
O' THIS TGt'�Sti+ 1GN INCLUDING ANY DAMAGF WHICH MAY BE INCURRED DO-- TO T►1E OIS�Jt.NFC'1C3t, 0$: ELECTRICAL r OwER IN THE EVENT OF VIOLATION of rMIS. ACvgH%1Ek-
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