HomeMy WebLinkAbout30 Day Temporary Power Releasee
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46-24161-�i FOX 771-:461-6443
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Date: Penik "Nf1rnbe'.\_n � ('0
Pr*d Address: \\-
THE UNDERSIGNED HEREBY REQUEST RELEASE OF ELECTRICAL POWER TO THE ABOVE DESCPJ13ED
PROPERTY, FOP, A. PERIOD NOT TQ lEXCeLD 7HIRTY (30) OAYS, FOR THE PURPOSE OF'
ANb EQUIPMENT iN'PREPAR TESTING SYSTEMS
., m-ON FOR A FINAL. INSPEMON. 'IN CONSWERATION OF APPROVAL OF THE
REQUEST WE' HEREBY ACKWOWLWGE AND AGREE AS FOLLOWS -
I, This ternPOMY Power release is requested for the above slzted purpose only, and 'Mere will be no
0cx42nCV Of. any We, other than that permittad by constucdon during this time peded.
2. As Witness. by our signakims, we heroby agree th abide by -all terms and -conditions of thfg agreemerit,
Includifig Building Divisioh Pblicy, which is Incorporated herein by reference,
3. AH conditions and requiremtnts fisted In the attached document entided'"Requlmments -fbr 30 Day
Power for TtsUng'7hay.e'beonfulfliled'acid the premise is ready for compliance inspection.
4. All nKueft for, an extension deyo . ' ryd 30 days -muSt be:made in wilting to the Bifficring'10Mciall -stating
thereatorffbrthe reepM -PoWermaybe• reinovedftm the site and/bra Stop work,-Orderl=ed If
thEi Final Inspecti6n has not Been -approved vftin 30 days. A fee of $100.00 will be n-Abired to lift
the Stop Work Order.
WE HEREBY RELEASE AND AGREE TO HOLD HARMLESS ST. WC7E COUNTY, AND THEIR EMPLOYEES FROM
ALL LIABILMES AND CLAIMS OF ANY TYPE� WHICH MAY APJSE NOW OR IN THE FUTURE OUT
OF TH1S tkANSACTI0N, IKLU. .- D10 . AN . 4 - Y VAKAGE WHICH 'MB AY E INCURAED IDUE TO THE
wcomwrm OF *ELECMCAL POWER Hq THE EVENT OF VIOLA-aoN OF THIS A4RMvANT.
DATE
DATE
FEB 113 2018
L8t-J W00/9000d 89ti-1 999L8L8ZLL -WOdJ LZ"-SL 8L,-CL-W