HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE19 14:49 FROM-
7728787656' T-832 P0001/0001 F-352 .
FaX -772-462-s4a
SCANNED
W
St Lucie bounty
Request'fbir:30-bi '7'emobi4tyPower Release
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UNDERSIGNED HEREBY RE -QUEST RELEASE or 8ZCMXAL;SoWER -ro THE ABOVE DESCRIBED
)ERTYr FOR A PERIOD NOT To EXCEED THIRTY M) DAYS, FOR THE PURPOSE OF'TMMG sygrr:MS
EQLUPMENT IN PREPARATION FOR A. FINALINSPECITON IN CONS16ERKfION OF APPROVAL or THE
Mr WE HEREBY ACINJOWIX0.0 AND kiii AS Ri
1. Tffttwipetary power release Is requeftd flor the above staled purpose only, and there will be no
occupancy of any type, other than that permitted by WhOuMon during ft time period.
�2-A§ witness by our qigrv.ftn*, We, h &&y agree t0 abide by all terms and ouriciltions of this agreemeM
including Bulldino Division PbW, which Is jnwfOdratLd h&C-h by reference.
3. AR conditions:anc1 requjrejhe;.,t5 listed .10 the attached doctzhent ehtfff6d "Pequlrerrients for 30 Day
Pow& for Tesftf have'been fbiffiled'and the premise is ready for compliance inspection.
.4. All requests far %in extendon b"nd 30 days must be made in writing to the Budding Official shAng
the reason' for the request PDw& maybe reftvedlrom the site and7br a Stop work Order Issued -if
the fibefInspection has not beenapprovedwkhn 30'days. Akeeof$100.00willberequired tolft
the Stop work Orden
HEREBY RELEASE-ANDAGREE 70HO '
HOLD HARMLESS, SL.LUCTE COUNTY, AND THEIR EMPLOYES FROM
LLqM1T1E$ AND CLAIMS OF ANY TYPE OF, NATURE WHICH MAY ARISE NOW OR I I NTHE FUTURE OUT
i'HIS TRANSACTION, INCLUDING ANY VAMA6E*kCWM'Ay BE !NCUFMD OUE TO THE
MME=N OF 8.i=cAL P=Ek INT" HE,: EVENT 6F: VMLA710M em: m4m iLaw-mmur
OWNER
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WE
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7=rdiCraSIGNATURE
EllliaRM
WE
RECEIVED
AUG 7: 2019
Department
Department
Permitting
L
Lucie County, FL 1]
St.