HomeMy WebLinkAboutNSFR2015-0657CITY OF GRAPEVINE
TEMPORARY GAS RELEASE
Temporary gas has been requested for the purpose of construction,
remodeling, addition or improvement to the following described
property. It is understood that this release In no wnv authorizes
occupancy of the bulldinn. It is further understood that thls temporary
release Is for a thirty (30) day maximum time period and the undersigned
releases all claims that may occur through accidents or spoilage of any
type resulting from said gas power being turned off at the end of the
thirty (30) day maximum time period.
ADDRESS LOCATION OF TEMPORARY GAS RELEASE:
ADDRESS: 33
CFe-6K_
PERMIT NUMBER: _ 16 � (I !SK
OF
in
-9300 /00
CITY STATE ZIP: 503y
TELEPHONE NUMBER: y6 y- a5a - a-a00
dry,' kM�1' MMkMYki* A* VrYtk�lk�hlpMNinMM�YiMWkMMwMMhY+ MrkOMrSNNwiYdi4RM' �htilYFNkA�Y/ t�1vF1MAV�yY�1kYrMRMRMrtMMrtHiYrdlhFR11
INSPECTIONS FOR TEMPORARY GAS MUTBEI�UESTED
AT (817) 410 -30
0
CITY OF GRAPEVINE
TEMPORARY GAS RELEASE
Temporary gas has been requested for the purpose of construction,
remodeling, addition or improvement to the following described
property. It Is understood AW. this release in no, wa y authorizes
occupancy of the bulldina. It Is further understood that this temporary
release is for a thirty (30) day maximum time period and the undersigned
releases all claims that may occur through accidents or spoilage of any
type resulting from said gas power being turned off at the end of the
thirty (30) day maximum time period.
ADDRESS LOCATION OF TEMPORARY GAS RELEASE:
ADDRESS: 3 � q ) r ( f
PERMIT NUMBER:
CONTROCTAR INFnouArinu
NAME OF APPLICANT:
q lj n
ADDRESS OF APPLICANT:
X500 �e- ,ec y Dr. SaitG J00
CITY STATE ZIP:
rp;-s co 5 0 3 (f
TELEPHONE NUMBER:
y6 9- a�a- a aoo
INSPECTIONS FOR TEMPORARY GAS MUST BE
AT (817) 410 -3010 /
SIGNATURE:
a1oroz
T N- ;E:L
E DATE: