Temporary Structure Permit Instructions by STLCOGOV

APPLICATION FOR TEMPORARY STRUCTURE PERMIT

Complete all sections on both pages except for the two sections marked “For Office Use”.

PROJECT INFORMATION & LOCATION:

WORK DESCRIPTION:

OWNER/TENANT INFORMATION:

ARCHITECT/ENGINEER INFORMATION:

PRIMARY CONTACT INFORMATION IF OTHER THAN APPLICANT:

Application Date

APPLICANT CERTIFICATION & INFORMATION

I CERTIFY THAT I AM THE OWNER IN FEE OR AGENT AUTHORIZED TO APPLY FOR THIS PERMIT, THAT I HAVE AN AGREEMENT WITH THE OWNER/LESSEE TO PREFORM THIS WORK; AND THAT I AM AUTHORIZED TO AND DO CONSENT TO ENTRY ONTO THE PREMISES BY ST. LOUIS COUNTY EMPLOYEES FOR INSPECTION OF WORK PERFORMED UNDER THIS PERMT. THE SCOPE OF WORK INDICATED AND COST ESTIMATES ARE TRUE AND CORRECT.

IF A PARTIAL PERMIT IS BEING REQUESTED, I REQUEST AUTHORIZATION TO PROCEED WITH THE CONSTRUCTION INDICATED IN ORDER TO ALLOW CONSTRUCTION TO COMMENCE. I

ACKNOWLEDGE THAT IF AUTHORIZATION IS GIVEN THAT I WILL BE PROCEEDING AT MY OWN RISK WITHOUT ASSURANCE THAT A PERMIT FOR THE ENTIRE WORK OR STRUCTURE WILL BE GRANTED. I AM RELEASING ALL LIABIITY, INDEMNIFYING AND HOLDING HARMLESS ST. LOUIS COUNTY, ITS OFFICERS, EMPLOYEES, AGENTS, AND ANY ASSIGNS FOR ANY EXPENSE, ERROR, OR OMIISSION RESULTING IN SUCH ISSUANCE. SHOULD IT BE DETERMINED AT ANY TIME BY ST. LOUIS COUNTY THAT THE AUTHORIZED CONSTRUCTION NEEDS TO BE REMOVED, MOVED, CORRECTED, OR MODIFIED IN ANY FASHION, THAN SUCH REMOVAL OR CORRECTIVE WORK WILL BE AT OUR EXPENSE.

Contractor Name & Address Tel No. Reg # Signature Fax # Date Printed Name Email Applicant Other Than Contractor □ Owner, □ Architect, □ Engineer, □ Tenant, □ Other ______________ Name & Address Tel # Reg # Signature Fax # Date Printed Name Email Page 1 of 2 (Print/Copy As A 2-Sided Document Is Preferred) Project Type: □ Commercial, □ Multifamily, □ Residential Project Name:____________________________________ Structure Type: □ Existing Building, □ New Building, □ Non-Habitable, □ Temporary Structure Project Address___________________________________________ _______ Unit/Suite/Floor_________ Zip Code__________ Locator/ Subdivision or Parcel No.____________________________ Building/Center Name _____________ _____ Lot No._______ □ Unincorporated County, or Municipality______________________________________ Fire District___________________ Brief description of temporary structure construction/set-up scope of work: Property Owner________ Last Name First Telephone Fax Email Owner’s Address Street Address City State Zip Code Tenant/Business Name _________________________________ □Existing, □ New* *If a New Tenant/Business indicate the Previous Tenant/Business Use _________________________________________ IfNewTenant/BusinessIndicate The PreviousTenant/BusinessUse _____________________________________ Name & Address Telephone Fax Email Name & Address Telephone Fax Email PERMIT NO.

TYPE OF WORK

New Construction Addition Alteration

Replacement Repair Foundation

Shell Interior Finish

Fire/Storm Damage

Occupancy

Miscellaneous Work

RESIDENTIAL

Single-Family Two-Family Townhouse(s)

Note: Two-Family and Townhouse type buildings must have independent dwelling units with individual entrances. No common areas.

TYPE OF STRUCTURE

MULTI-FAMILY

3 or 4 Multi-Family

5 or more MultiFamily

Units/Building Units/Permit___________

Note: Multi-Family buildings have common areas such as common entry stairs, corridors, hallways, breezeways, and/or common basement areas.

BUILDING – TEMPORARY STRUCTURE

Type of Structure: Membrane Structure, Stage/Platform Structure, Tent, Trailer on Wheels, Other (describe)__________________

Size of Structure: Area _______ sq. ft., Width: ______ ft., Depth/Length _____ ft.

The structure has the following built-in systems/facilities (check applicable boxes): Heating system, Cooling system, Toilet facilities w/ holding tank If the structure does not have built-in toilet facilities, indicate below the location of the nearest toilet facilities that will be available to the occupants of the temporary structure: Location: Distance away: ______ ft

Intended use of structure: ____________________

Hours of operation: ________ _, Dates of operation: For food & beverage service facilities list the items offered and provide copy of menu:

Structure is owned, leased/rented by the applicant If leased/rented, applicant shall complete the following:

Structure owner: ___________ _________ Contact person: _________________

Owner’s address: Phone #: ____________

Applicant’s anticipated removal date:

(must comply with criteria below)

Note: Permits for membrane structures including tents are limited to less than 90 days. Permits for all other temporary structures are limited to the time of service or length of season, not to exceed 6 months. Temporary classrooms may be erected for a maximum period of 9 months. Unoccupied display structures and subdivision sales offices may be erected for a period of up to 1 year. All temporary structures must be removed from the site by the expiration date of the permit.

Comments/Information: ___________________________________________________

Other Permit References: _______________________________

Estimated Cost of Temporary Structure and Installation: $

FOR OFFICE USE

COMMERCIAL

ASSEMBLY

Theatres

Restaurant

Night Club

Churches/Religious

Recreation Center

Exhibition Hall

Banquet Center

Taverns & Bars

BUSINESS

Office/Bank/Professional

Carwash

Clinic

Fire Station

Doctor’s Offices

Laboratories

EDUCATION

Schools

Child Day Care

FACTORY/INDUSTRIAL

Manufacturing Plant

Industrial Laboratories

Utilities

HIGH HAZARD

Flam. & Comb. Liquids

Storage or Manufacturer

Tire Storage (Bulk)

Other High-Hazard

Storage or Manufacturer

INSTITUTIONAL

Nursing Home

Day Nurseries

Hospitals

Jails

Residential Care and Assisted Living

MERCANTILE

Retail/ Wholesale/Stores

Service Station Markets

RESIDENTIAL

Dormitories

Hotels/Motels

STORAGE

Office/Warehouse

Lumber Yard

Repair Garage

Parking Garage

Record Check____________________ Permit Expiration Date: ________________

Violation Check__________________

Transient Employer Documents

NON-HABITABLE

Antennas

Attached Garage

Barn

Carport

Detached Garage

Fence

Fireplace

Generators

Patio Cover

Patio/Deck/Porch

Pergola

Res. Greenhouse

Retaining Walls

Shed

Signs

Solar Panel/Array

Swimming Pool Tanks

Tower

Trash Enclosure

Other

Parking Lot

FOR OFFICE USE

Zoning Dist. ___________

Gov’t / Public Owned

PERMIT FEES

Processing ____________

Building ____________

Electrical ____________

Plumbing ____________

Mechanical ____________

Drainlaying ____________

Piers

Foundation

Land Disturb.

Inspection ____________

Penalty _________

_________

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___________ Total Fees ____________ Filing Fee Pd Balance Due ___________ Fees Paid ____________ Date Issued _____/_____/____ Issued By _____________ APPROVALS & DATE Est. Cost ______________ Zoning Rev. ____________ Plan Rev. ______________ Box No. ______________ Folder

Notified__________________Date______ #OP_____________ PA PAC No. _________________________ Flat Closet Permit No._________________________ Page 2 of 2 (Print/Copy As A 2-Sided Document Is Preferred)

TEMPORARY STRUCTURES SUBMITTAL INSTRUCTIONS

Please allow a minimum of four (4) weeks for processing the application after being received by the Department of Public Works.

The following information is required to be submitted in order to obtain a building permit to erect, place, or construct a temporary structure:

1. A completed application for Temporary Structure permit. Application forms are available at the Public Works Permit Counter.

2. A cash surety deposit (see attached form) or a performance bond (see attached form) made payable to the “Treasurer of St. Louis County, Missouri” for the following amounts:

Structures or trailers used as residential subdivision sales offices ……………………….

Tents, including tent canopies:

 Tents larger than 2000 sq. ft. up to 10,000 sq. ft………………………………………



larger than 10,000 sq. ft

Trailers on Wheels (other than above real estate or sales offices):

 Snow cone & similar small trailers up to 200 sq. feet…………………………………

 Single wide trailers up to 1000 sq. feet…………………………………………………$500.00

Stages (without roof/canopy):

 Stages larger than 500 sq. ft. up to 1000 sq. ft…………………………………………$200.00

 Stages larger than 1000 sq. ft…………………………….$500.00 plus additional $100.00 for each additional 500 sq. ft. or fraction thereof.

All Other Temporary Structures

 All other temporary structures……………………………. Minimum of $500.00 for structures (such as membrane covered cable up to 1000 sq. ft. For structures or frame structures, air-inflated or greater than 1000 sq. ft. a minimum air-supported structures, large trailers of $1000.00 plus an additional on wheels, structures with removable $200.00 for each 500 sq. ft. or fraction wheels, structures on skids, stages thereof. with roof canopies, etc.)

Note: The Code Official may, at his discretion, set a higher bond amount on large unique structures that are more permanent in nature and not easily removed.

Cash escrow/Bond amount listed is for each temporary structure (i.e., 2 subdivision sales trailers would require a $2,000.00 cash surety deposit/bond amount).

Permits for tents and tent canopies to be used for sales promotions or display shelters and those used on church property for worship or other religious purposes may be issued without posting a cash surety deposit/performance bond.

The cash surety deposit /bond shall guarantee the removal of the structure at the direction of the Director of Public Works or upon expiration of the permit. Please see the “Cash Surety Deposit/Temporary Structure Bonds Information” sheet for an acceptable cash surety deposit/bond format.

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TYPE OF TEMPORARY STRUCTURE CASH SURETY/BOND AMOUNT

……$1,000.00

$500.00

Tents

………………………………….……………………..$1,000.00

$200.00

3. Six (6) site plans showing the location of the structure in relation to any other existing structures on the site and the distances to the property lines. Please contact County Zoning Review, 314-615-2525, or the Zoning Official of the contracting municipality, if within a contracting municipality, for placement restrictions for a particular parcel.

4. Six (6) complete sets of plans identifying how the structure will be anchored and or braced to resist wind loads referenced by the County Ordinance 24,444, Chapter 1115 SLCRO and Chapter 16 of the ’09 IBC as amended. St. Louis County Public Works reserves the right to request plans and/or structural calculations prepared and sealed by the appropriate Missouri Registered Design Professional.

5. Four (4) sets of plans and details for anything that is to be field constructed (i.e. entrance stairs, landing, ramp, deck, canopy) and/or four (4) sets of plans for the temporary trailer.

6. The flame resistance of the tent fabric shall be verified by an affidavit documenting the following information for all tent structures:

a. Names and addresses of the owners of the tent structure.

b. Date the fabric was last treated with flame resistant solution.

c.Trade name or kind of chemical used in treatment.

d. Name of person or firm treating the material.

e. Name of the approved testing agency and test standard by which the fabric was tested. The membrane material shall meet one of the following criteria:

Noncombustible (Section 704.4) or

Flame resistant when tested in accordance with small-scale and large scale tests in NFPA 701-96. or

Treated in an approved manner to render the material flame resistant.

7. All temporary structures shall either provide, or have nearby access to, an adequate water supply, plumbing facilities, and sewerage disposal in accordance with the Plumbing Code, Chapter 1103 SLCRO, as amended. If the temporary structure has toilet facilities within, the applicant must provide a letter to Plumbing Inspections specifying the method of sewage disposal (i.e. temporary hook-up to sewer line, holding tank, etc.). Include a copy of the contract with the waste hauler, if a holding tank is to be used, with the letter.

Jim Showmaker, Plumbing Inspections (314-615-0330) St. Louis County Public Works Department 41 S. Central Avenue, 6th Floor St. Louis, MO. 63105

8. Zoning approval from St. Louis County Zoning Review (314-615-2525) or from the Zoning Official of the contracting municipality if the temporary structure is to be located within a contracting municipality.

9. Fire District or Fire Department approval. (see attached form)

10. Property Owners or Lessee’s Permission form sealed, signed and dated for St. Louis County or a municipality contracting with St. Louis County to enter the site. (refer to attached form)

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TEMPORARY STRUCTURE CASH SURETY DEPOSIT INFORMATION

In order to obtain a temporary structure permit, the owner and/or operator of the temporary structure may be required (see submittal instructions) to post a cash surety deposit for the stipulated amount with the Treasurer of St. Louis County, to guarantee removal of the structure upon expiration of the permit or at the direction of the Director of Public Works.

The cash surety deposit submitted shall consist of:

A) The temporary structure cash surety deposit form. (Must be signed and dated by the owner/operator of the temporary structure)

B) Cash, money order, or check for the stipulated sum to be deposited with the Treasurer of St. Louis County.

The temporary structure cash surety deposit shall be submitted in the same form as the attached sample without alterations.

TEMPORARY STRUCTURE BOND INFORMATION

In lieu of providing the cash surety deposit noted above, a performance bond must be posted to guarantee removal of the structure upon expiration of the permit or at the direction of the Director of Public Works.

The bond submitted shall consist of:

A) The temporary structure bond. (Must bear the seal of Surety Company and Principal if a corporation.)

B) The power of attorney.

C) The notary acknowledgment.

The temporary structure bond shall be submitted in the same form as the attached sample without alterations.

Revised 03/07/02

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St. Louis County Counselor TEMPORARY STRUCTURE CASH SURETY DEPOSIT

I/We as owner(s) and/or operator(s) of a temporary structure proposed to be located at ______________________________________________ are held firmly bound unto (address of temporary structure location) The Treasurer of St. Louis County, Missouri a cash surety deposit in the sum of ___________________________________ Dollars ($_____________) for which sum we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

The Condition of this obligation is such that

WHEREAS, I/We have requested that I/We be granted a permit by St. Louis County to construct a temporary structure at ______________________________________________________________ ____________________________________________________________ (hereinafter referred to as “temporary structure”); and

WHEREAS, I/We agree that upon the expiration of the building permit or lawful extension thereof, authorizing this temporary structure, the temporary structure must be removed from its site noted above and that site returned to its condition immediately prior to the construction of the temporary structure (hereinafter referred to as “original condition”);

WHEREAS, I/We agree that if the temporary structure is not removed upon the expiration of the building permit or lawful extension thereof, authorizing the temporary structure, St. Louis County may cause the temporary structure to be removed and/or demolished and the site returned to its original condition; and

WHEREAS, I/We agree that this cash surety deposit is to reimburse St. Louis County for all reasonable expenses incurred in the removal and/or demolition of the temporary structure and in any work necessary to return the site to its original condition;

NOW, THEREFORE, I understand that if I comply with all applicable ordinances of St. Louis County or any municipality within St. Louis County and upon expiration of the building permit authorizing said temporary structure, remove the temporary structure and return the site to its original condition, then this obligation to be void; otherwise, this obligation shall remain in full force and effect.

This cash surety deposit shall be construed to cover the interests of any Municipality in St. Louis County and shall be available for the protection of such Municipalities and the residents of St. Louis County and any Municipality within St. Louis County.

This cash surety deposit shall remain in effect until the Director of Public Works, or his designee, has inspected the site and is satisfied that the temporary structure has been removed from the premises and the site returned to its original condition. Once the temporary structure has been removed and the site restored to its original condition, I/We may request that the cash surety deposit be returned.

Temporary Structure owner/operator Name: ___________________________________

Signature: _____________________________

Date: _____________________________

STATE OF MISSOURI)

COUNTY OF ST. LOUIS) SS

On this __________ day of ______________________, 20____, before me personally appeared ____________________________________________, who being sworn, stated that he/she is the person named above and that he/she executed the same as his/her free act and deed.

IN WITNESS WHEREOF, I hereunto set my hand and official seal. __________________________________

My commission expires: Notary Public

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TEMPORARY STRUCTURE BOND (SAMPLE)

KNOW ALL MEN BY THESE PRESENTS, that we, (Name of Principal) as Principal, and the (Name of Surety Company) , a (State) corporation, as Surety, are held and firmly bound unto The Treasurer of St. Louis County, Missouri, as Obligee, in the sum of _________________

________________ Dollars ($_______________) for which sum, well and truly to be paid, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

Signed, sealed, and dated this ______ day of ____________________, 2_______.

The Condition of this obligation is such that

WHEREAS, the Principal has been or is about to be granted a permit by St. Louis County to construct a temporary structure at (Location of Temporary Structure)

(hereinafter referred to as “temporary structure”); and

and that site returned to its condition immediately prior to the construction of the temporary structure (hereinafter referred to as “original condition”);

WHEREAS, the Principal and Surety agree that if the temporary structure is not removed upon the expiration of the building permit authorizing the temporary structure, St. Louis County may cause the temporary structure to be demolished and the site returned to its original condition; and

WHEREAS, Surety agrees to reimburse St. Louis County for all reasonable expenses incurred in the demolition of the temporary structure and in any work necessary to return the site to its original condition;

NOW, THEREFORE, if the Principal shall comply with all applicable ordinances of St. Louis County or any municipality within St. Louis County and upon expiration of the building permit authorizing said temporary structure, remove the temporary structure and return the site to its original condition, then this obligation to be void; otherwise, this obligation shall remain in full force and effect.

This bond shall remain in effect until the Director of Public Works, or his designee, has inspected the site and is satisfied that the temporary structure has been removed from the premises and the site returned to its original condition.

Revised 04/11/01

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TEMPORARY STRUCTURE BOND

KNOW ALL MEN BY THESE PRESENTS, that we, ____________________________ as Principal, and the __________________________________________________, a _________________ corporation, as Surety, are held and firmly bound unto The Treasurer of St. Louis County, Missouri, as Obligee, in the sum of _________________ ________________ Dollars ($_______________) for which sum, well and truly to be paid, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

Signed, sealed, and dated this ______ day of ____________________, 2_______.

The Condition of this obligation is such that

WHEREAS, the Principal has been or is about to be granted a permit by St. Louis County to construct a temporary structure at __________________________________ _______________________________________________________

(hereinafter referred to as “temporary structure”); and

WHEREAS, the Principal and Surety agree that upon the expiration of the building permit authorizing this temporary structure, the temporary structure must be removed from its site at _________________________________________________________ _____________________________________________________________________

and that site returned to its condition immediately prior to the construction of the temporary structure (hereinafter referred to as “original condition”);

This bond shall be construed to cover the interests of any Municipality in St. Louis County and shall be available for the protection of such Municipalities and the residents of St. Louis County and any Municipality within St. Louis County. This bond shall remain in effect until the Director of Public Works, or his designee, has inspected the site and is satisfied that the temporary structure has been removed from the premises and the site returned to its original condition.

Revised 04/11/01, 10/11/10

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ACKNOWLEDGEMENT OF PRINCIPAL (Firm / Corporation / Individual)

PRINCIPAL:_________________________________________ (contractor's company name)

By: ________________________________________________ (signature of company's responsible officer) (name and title typed or printed below)

STATE OF ______________________ )

COUNTY OF ____________________ ) SS

On this _________ day of _______________, 20 _____, before me personally appeared _____________________________ (name of company officer) the above signed officer who acknowledged himself/herself to be the ___________________(title) of ______________________________ (name of company) and that he/she as such officer being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the ______________________________ (company name) a _______________________(company/corporation/partnership) by himself/herself as such officer.

In witness whereof, I hereunto set my hand and official seal.

My commission expires:_____________________

__________________________________________

Notary Public

ACKNOWLEDGEMENT OF SURETY SURETY: ______________________________________

(Name of insurance / bonding company)

By: ____________________________________________

(Signature of Attorney-in-Fact)

STATE OF ______________________ )

COUNTY OF ____________________ ) SS

On this _________ day of _______________, 20 _____, before me personally appeared ____________________________________, who being sworn, stated that he/she is attorney-in-fact for surety, _____________________________________, and that he/she signed this instrument as attorney-in-fact for the foregoing surety. _________________________________________

My commission expires:_____________________

Notary Public

APPROVED AS TO LEGAL FORM:

_________________________________

St. Louis County Counselor

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FIRE PROTECTION DISTRICT OR FIRE DEPARTMENT APPROVAL OF TEMPORARY STRUCTURE PERMIT

TO: Temporary Structure Permit Processing Department of Public Works Code Enforcement Division

St. Louis County Government Center 41 S. Central Avenue, 6th Floor Clayton, MO 63105

FROM: __________________________________________________________ (FIRE PROTECTION DISTRICT OR FIRE DEPARTMENT)

County Application No.: _______________ Municipality: ________________

Applicant’s Name: ___________________________ Phone Number: ______________

Mailing Address: _______________________________________________________

Address & Location of Temporary Structure___________________________________

Proposed Use of Structure: __________________________________________

Date of Usage: From_______________________ To _______________________

FIRE DISTRICT OR DEPARTMENT APPROVAL OF THE TEMPORARY STRUCTURE

As required by Section 3104.16 of St. Louis County Ordinance 20311, 1-05-01, approval is hereby given by the Fire Protection District or Fire Department for the Temporary Structure noted above.

Approved by: ____________________________________ Date: ________________

Title: ________________________________________________________________

Note: Applicants for Temporary Structure permits must submit this form verifying Fire Protection District or Fire Department approval of the temporary structure to St. Louis County, Department of Public Works before a permit can be issued for the structure. All temporary structures must be removed by the expiration date of the permit. Permits for membrane structures including tents are limited to less than ninety (90) days. Permits for all other temporary structures are limited to time of service or length of season, not to exceed six (6) months, except for classroom structures which are permitted for ten (10) months, and unoccupied display structures and subdivision sales offices which are permitted for a period up to one (1) year.

Revised 02/12/13

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PROPERTY OWNER’S OR LESSEE’S PERMISSION FOR ST. LOUIS COUNTY OR MUNICIPALITY CONTRACTING WITH ST. LOUIS COUNTY TO ENTER THE SITE

This is to certify that I am the owner or lessee, or authorized legal agent of either, of the property (land) located at _________________________________________________ (address of temporary structure location) being the site where a permit to construct a temporary structure is requested from St. Louis County Department of Public Works (hereafter referred to as “St. Louis County”).

I understand that before such permit is granted by St. Louis County the owner/operator of the proposed temporary structure may be required to provide St. Louis County with a performance bond or cash surety deposit to ensure the removal of the temporary structure should the owner/operator of the temporary structure fail to remove the structure upon the expiration of the temporary structure permit.

Should the temporary structure owner/operator fail to remove the temporary structure by the permit expiration date, or lawful extension thereof, I _________________________, as the property owner or lessee, or authorized legal agent of either, having the authority to grant permission as noted herein, hereby grant permission to St. Louis County or any municipality within the County that contracts with the County for code enforcement, or their agents, to enter the site for the purpose of removing or demolishing the temporary structure and any work necessary to return the site to its original condition.

IN TESTIMONY WHEREOF, I execute this instrument and accept the above understandings and conditions of approval for the temporary structure permit.

Property Owner’s, Lessee’s or Agent’s Signature

Printed Name ______________________________ Phone# ____________________

STATE OF MISSOURI) COUNTY OF ST. LOUIS) SS

IN WITNESS WHEREOF, I hereunto set my hand and official seal.

My commission expires:

Revised 02/12/13

Notary Public

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_______________________________

Date _______________________________