HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE17728787656 T-265 P0002/0002 F-399
03-22-5 1 �4L�i I
M 4 LV
BY
RECEIVED
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MAR 2 2 701.9
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Perrn'tting DePartm,,�
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72t6!2� St. LuCle cbur�.
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Rlelqutft*%r,3(y-bay-y,.erni%bm'ry 'Power Release
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Dab -a- Permit ftnber.
PMwt Address; �A
THE UNDERSIGNED HEREBY REQuEgr RELEASE OF BZCM= POWER To -TH A13QVr
z DESMMr
PROPERTY, �OR A PERPO'NOT To rz E =D
xcfjo TFjjRTy.(30) -pAyS, 'FOR -niE PURPOSE OFTESMG SYSTEM
AND EQUIPMENT IN PREPARATION FOR ARNAL INSPECMN. IN CONMERATION OF APPROVAL OF THE
P&Qm§T vie Hetegy k*OWLEDGE,AND VREEA5 FOLLOWS:
IN$ tanPmrY POWK rddm is requaU.0 1br the abm stated pumm ody, and tm wM be ro
OM418nCY Of arW We, �ther than that perrartted by MiW=Cdon . dUring ft t1me pend&
2. AswthewbY.0vr4naWp.w, We hereby aqr�.,_e tb Widp bY all W M-8 altd CoWitions of ft agreameht,
1j1dudlqg BuAillng Viviqon Policy, which is In6orpOrated heseqn by reference.
3. AH condftns and requiremerft fi�W In the atta0ed document entided -Requimm" fbr M Day
Power 'fbr Ta-ftg- have been fuMiled'and the prenji5e is rmdy fbr compliance inspectiom
4. All'reqluWt forBn e)ftn!�Fton beyond 30 days inust be -made in vmling to t hm Bundingofficia swtfng
the re4on'fortlie request -PoWer!na� bd remowftmm the sm and/br a sbp Work Cirder issued IF
tM *91 InspecUon hai nut bimn approv�d �46n 3o day.s. A fee of $100.0o- wm be reqUired to Ipt
the ftP Work Order.
WE HMESY RELEASE AND AGREETO HOLD K4
. ...RMLESS, ST. LUCIE MUNTY, AND THEIR, EMPLOYEES FROM
ALL LTABLrrX
SAND CLAIMS' -OF ANYTYPE: OF NATpAE MICH MAY AR 611 IN INE FUTM OLrr
ISE NOW
of: This TR, ".Acripm imcw- D AMAOE WHICN-AAY BE INCURED DUE M THE
jh(3 AMY 1)
=45hNkWN O�: kkTpdai POWFA IN, THE, EVEW OF MA174DN OF TKX AGMEMT.