HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASEr :F
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Fort Flee,. a 349& . Nov g 2 2012
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5t. LUCle County
Re4uesf fair 30, Day,Ternporary,e9 SCANNED
a BY
Date, 1 2 � � ; St. Lucie CougV
Permit Na:ft*fber, /4,7 li `-¢" fr,
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TFlE #JNDERSIGNEQ
REBY REQUEST RE
PROPER T Y,_ FOR A 9ERIOD Nt}T T O EXCEEi3 E OF ELEC7itICAL POi�'ER 70 THE ABOidE ti! SCRIBED'
A;4D EQUIP #ENT IN PREP THIRTY {3I3) DAYS: COR THE PURPOSE flF �ESTiN� 5153 EMS
ARATiON FL3R A FINAL'INSFECTtON. TfONSIfIERATTON ?3P APPROVAL {jF THE
REQUEST 1#sfE'HEREBy ACKNOWLEDGE AND AGREE, AS'FOLLCiVuS,
L 'i'his temporary power re ease is regUu ed far the. above stated purpose only and:ttiete wii3 be no
uPanq= of arty sign, other than.t aat pamrJdad 5y �tuation durIhg this time period.
2. As witness hiding s#griatares, we harwhich' agree to abide by all terms and Gond#toos or this agreement,
Inc3ud#ng Ons and requfon pojts listed
which f is Incorporated herein by �fe; enca.
3. 'Po Power
T s and rhave rants l s � in the &ached docsre?r t ent;#ed "Re�1#re T er Gs far 3�i Day
Power for T sting." have fiae�S faWdIlsd and the premise is ready for titled "Req: inspcements f
4, fieerierequests forhe requeeXterst. beyond §p d'ys ni be made in writing to the Sulfdln rfl�cial sating
the reason #ar the request. Pos er maY be` removed from the andlor a Step �Jork 0rdes ssuctil #f
the Trial Inspection has -not been apprauer w iin 3t} days, A fea of ?i90.�p vadA titre required to lift
the Slap *Nock Order.
AL ,I tIEREBY RELEASE AND AGREE TO i K}GD HARMLESS, ST. LUCiE COs li fC y AND [ EiEiR EMPLOYEES FROM
1
ALL LIABILITIES Ahp CLAIMS OF ANYTYpE OF NATURE LVHICy'(?A! ARISE OW flR IPI THE FUTURE
O TP#IS TRANSACTIONOUT
; INCLUI3iNG ANY �"Ai It jFiiCHgY :BE, IN£UE3}kFt3 fJtiE IO ?tE
Li $CC)i NEc'I?ON,OF ELEjCI17 gg +r ITV TH'e E TENT OF �lTC7! A ft[1h t3k r rrc n r era, , n