875—66.5 (17A,89A) Content of petition. A petition for waiver shall include the following information where applicable and known to the requester:
	 66.5(1) The name, address, and telephone number of the entity or person for whom a waiver is being requested; the case number of or other reference to any related contested case; and the name, address, and telephone number of the petitioner’s legal representative, if any.
	 66.5(2) A description of and citation to the specific rule from which a waiver is requested.
	 66.5(3) The specific waiver requested, including the precise scope and duration.
	 66.5(4) The relevant facts that the petitioner believes would justify a waiver under each of the five criteria described in rule 875—66.3(17A,89A). This statement shall include a signed statement from the petitioner attesting to the accuracy of the facts provided in the petition and a statement of reasons that the petitioner believes will justify a waiver.
	 66.5(5) A history of any prior contacts between the board, other departments or agencies of the state of Iowa, or political subdivisions and the petitioner relating to the elevator, escalator, or other equipment affected by the proposed waiver.
	 66.5(6) Any information known to the requester regarding the board’s action in similar cases.
	 66.5(7) The name, address, and telephone number of any public agency or political subdivision which might be affected by the granting of a waiver.
	 66.5(8) The name, address, and telephone number of any entity or person who would be adversely affected by the granting of a petition.
	 66.5(9) The name, address, and telephone number of any person with knowledge of the relevant facts relating to the proposed waiver.
	 66.5(10) Signed releases of information authorizing persons with knowledge regarding the request to furnish the board with information relevant to the waiver.
	 66.5(11) The state identification number of the elevator, escalator, or related equipment.
	 66.5(12) The age of the conveyance.