HomeMy WebLinkAbout30 DAY TEMPORARY POWER RELEASE03-04-'20 11:53 FROM- 7728787658 T-627 P0003/0003
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SCANNED
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St. P iiriprminti
Date: �ire \(toq -- DI -A cz
RgectAddressQV.-eoi, Q
THE UNDERSIGNED HSW5Y REQUEST RELEASE OF ELECTRICAL Pr3WER TO THE ABOVE DES(giIDlD
PROPERTY, FOR A PERIOD NOT To. E)CCEED THIRTY (30) DAMS, FOR THE PURPOSE OFTESMG SYSTEMS
AND EQUIPMENT IN PREPARA rioN FOR A FWAL.INSPECTION. 'IN CONSIDERATION OF APPROVAL OF THE
REQUEST WE' HERESY ACiQtiOVl>1.EDW AAi b AWEE-A8 Fb1.i.ows:
i. Th's terr>porary power release is requested fOrte above stated purpose only, and there wiH be no
Parm
Y anY type, PYlter than t#YaE permitted by bpi i5trudion during this time period
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2. 4s'witrtess by our strts, we fiery agrP€.tb abide by farms and caidrimns of this agreement,
ttclding Bulldiru} bivi�on policy, winch is incorpol�ted he�in hY reYerertce.
3. Ali condrbbns and requ►reihems iisfed in tfie attar document enffiJed "Repuirementsfior 30 Day
Powerfor Tes[irlg> hauebet?n fl,iGllecj aT>d the pn�nise is r�adyfor mmpiia inspection,
4. Ail regUeS fnr an extension heYcnd 3a days must Lte'rnade In enitfiig ko the Bu8din9ftdal Slating
tgre reason fore request Paver may be removed from the stite and�or a Stop Work Order issued Jf
the Final i Vetlion has not f)een approved Wditin 3o'days A tee'of $100,00 will be tegcrired to Cdt
the Stp Work Carder.
WE HEREBY RELEASE -MD AGREETO HOLD HAAMILEK ST, LU¢E GOUNTY, AND THEIR EMPLOYEES FROM
ALL LLOR TIE$ AND CLAIMS'OF ANY TYPE' OF iylATURi_ wHIf H MAY ARISE NOW OF, IN THE RMIRE OUT
OFTht],5 TRAN5ACIIgN, INCLUDIM3ANY -DA.MAGE-VWJ-QCf4'MAY BE INCUwzb QUETO'THE
DISCONNIECaON OF E1,EL`Iltity;L POwiK M THE EVEW OF VIC1LA7ION OF THIS AGPEE M