HomeMy WebLinkAboutPermit Vent-Free Heater 2019 - Permits - 29 MILTON STREET 4/12/2019 UP
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Application for Standard Permit
(Rev.1.1,2018) Return C13MPlated application to.
Permit Number
DIG SAFE NUMBER
City or Town:
I —
A jl� � VG 112
Date Start Data:
In accordance with the PTOVilalorlb of KG,L,ChlePIST148,as provlded)n Section---.application Is hereby made
by ' ' ' ' 1-1 1rl n --
G 0� 1----)7 ?(Full Name of Person,Firm or 5orparallon)
of I (PhonerNum
Q0 &ffiLj.L i LL— M A-4- o laz 0
(Add.. 3"Tqgl or P.D.Box,olly or Town,zip�&)
for p0rMISM16 to(state clearly purpose for*10h Permit is requested)
r� ter
Cart, Na
Date Issued rejel;w.
gy
Date of expiration (Signature 01 Applicant)
Amount Paid$
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FIR-0136 nov
(Rev.1.1,2016)
PERNT
City orTown:
DIG SAFE=NUMBER
Date:
Permit Number(if OPPIloable)-, Start Date,,
In accordance with the provisions of KG.L.Chapter 14B,as provided In
to
this permit Is granted
(Full Name of Person,F or Carporel on)
for
Restrictions:
rticn�rdeqoale�ld;rjlf�joatjon)
(Siraat and or rialorlb,"011
Fee Paid$ Th pe, Will expire on
Signature Of Official Granting Pe
rmits
-Title
W� This POrMit Must be congPiCuOuSlY'Posted upon the promises *E