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3330 SOUTH 1300 EAST Millcreek, Utah 84106 [PHONE REDACTED] Millcreek.us Utility Connection Agreement GAS ELECTRIC I, , the undersigned, hereby request that the following utility connection(s) be made to/ for a building or structure herein described, for the purpose of construction. I understand and agree that the structure described herein will not be occupied nor used for any purpose of construction thereof, authorized by a valid building permit, and pursuant to Millcreek Municipal Code 15.08.015. Use and/or occupancy shall not be permitted until all approvals from all departments have been granted, and the final inspection has been approved and/or a certificate of occupancy issued. I agree that no connection to any utility shall be made pursuant to Millcreek Municipal Code 15.16.030. I further understand and agree that the failure to comply with any part of this agreement, by myself, or those in my charge, may result in the following action(s) to be taken against me by Millcreek in order to obtain compliance herein: 1. Preclude any approval of utility connections related to any other active permits held by me 2. Notify the State of Utah Division of Occupational of Professional License to appropriate action against my license 3. Take legal action against me personally pursuant to Millcreek Municipal Codes 4. Request that all utility connection be removed by the utility company I furthermore agree to hold harmless Millcreek and the utility company for any loss, damages and claims arising from the enforcement of this agreement. Owner/Contractor: Phone # Permit # Address