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HomeMy WebLinkAboutPermit - Propane Fill Station 2009 - LP Gas Tank - 4 MAIN STREET 1/21/2009 7:9 C; ffla P6(rev.3/00) APPLICATION FOR PERMIT City or Town WrY+k M&Ye-r DIG SAFE NUMBER Date I Start Date: In accordance with the provisions of M.G.L. Chapter 148, as provided in Section i0A at S;-7_ application is hereby made by RIU2 (ZhIM (Full name of person,Firm or Corporation) Address C211-b�a- iCi 420 L 1 (Street or P.O.Box)(City or Town) For permission to (state clearly purpose for which permit is lrequested) e )I 'n QC:)P0 9- b_ dpoA 10 0L 12UM P(-,'Qa- CQ I ar I ' � 1/ 11- 0 t )rah-A IA Name of competent operator (If Applicable) A Cert. No. Date Issued-rid By (Signature of Applicant) Date of expiration Fee $ Paid Due -- ——————————————-- ———————————————————————————- d/ P6(rev.3/00) PERMIT City orTown DIG SAFE NUMBER Date Star Date: Permit Number (if applicable) In accordance with the provisions of M.G.L.Chapter 148, as provided in 10A this permit is granted to F- UnL4 9 -- Oain-,- n+ [��06G-Lnid &Q A Q- -r-C1, (Full name of person,Firm or Corporation) for � bamR , CAJAors 17-c) LP,, 4 C IrO �Inm�Icffld cc Restrictions: 52-77 C-�'"` RA , 59 at 94 ck-CICILP (Give location by street and no.,or describe in such manner as to provide adequate identification of location) Fee Paid $ This Per Kxpir, on .4 Signature of Official Granting Permit Title No This permit must be conspicuously posted upon the premises 411111111111