1655 ATLANTIC BEACH DR - EARLY POWER .1f1:11i%
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CITY of ATLANTIC BRACH
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Electric potter is Tuxesiad rzowtnder the cQ 5tt on- d terms of th(stIlly execured Ag,,;emait&Releese
Sob Ad$rrcr —'J �b T ✓.�! / 0
rL/1vy/C 13C/fiC'/ is - 3 22:33
P&ttn!t No. l ?_ $/--/'- 2%00 Service ip),te(avec.one); Overhead tdergrouitd
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Uro yodel-signed Oenernl Contractor and$Icohiclan,•unders?and.andagreot
I: `:Pruly Pinna_ ;srpiurlly for our cptrstti(ctloir o:tvclt cc, it is trot required.by Godes and does Let
st'gsittnfsFars ota :4pect:onsoctheGO(Cent.ecatecPOccup wcyjlCialmnstbeisscedbeforeecopre-xy,
enc ass;ca fiinaisn'etion o (tic Building Oatial.
2, tiro divotAtlnotic Beach Mil mnke:e fp tiler ins-plc-lion prior to the carry pootci trusgizing. Al)rough
inspections(Dusthaveprio 4pp;:oval,iaGudiugmeterbase.corniections. j
Ogcttprne''br use o°yiac nets corstrliction before a form ii CIO constihrtes fraudulent use of the earl
elc_-tro service. Stroh acetol: is expressly ITIb15ed 8ttrl pe%rallzed by :TheCl(y of Atlantlo Beau
ione
Ordi os. Aq oto atiol of 1111:s.Lgreelneat ssrr 1 result Ina request for.premp:removal of:elcctric-service •
a3er r.•ttreoty-four 11041"notice.
4. ")arty Power"release.npsbcrity is the t31ec!rician enc%p rtllc Contractor acd meal not mart before:
" Eclm ment,de'oes�y'p4f si,,resale installed( r btarkcd offj salols••
b. Pauel19 c'otnpiete\&1 grotkeq'end cover anct(lzbehng requiredal final inspection), •
c• Saylcec'o..rtcclonaa0gro�JtIJna!rg.is�oomp`letc.,.
The el eofric sys!ean bas safe!),Passed thrgt;gb clectriral Check.
Meta can Is patrito ept}y n e ed tv17 i address
Teorperery ntirlressmrnce s displayed(Ptnnirrient numbers are requfredlbr Clb).
5. This fully completed form is to besulim tied to the8tiilrrtag Department by hand,mail or•fmt.
irbhtremwli Agrccmcnts will not be accepted(ram nose Ivhco,IOn!e toy ode of The above:tern .
CO3CRANtilt. //.7 DhTJ: 912�l/7
PRYRFNAME' /Pr, j�vrfc^
renir24,i�.� ,p �� , DATE 9-29-r�
Pflfl'TWA .,' �'/v• {v.
BOO ScI:Bolo:Coag Arbnflo'3:adt PL32233
Phone:(704)2275!26 Paz;(904247.5845 liftp:/Avwri.otir.b.us rcvistd 01 IVO.%
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