HomeMy WebLinkAboutLP Permit - Combustible Storage Tank - 712 SHARPNERS POND ROAD 2/12/2016 ��ZP C 2
0�J9?%?
o Application for Standard Permit
FP-006 0► Return completed application to: (■
(Rev.04/12)
Permit Number: ,,,,�� // DIG SAFE NUMBER
City or Town: All c\1� A Koko U 1'
D 2 //Z / Start Date:
Date: l
In accordance
with the provisions of M.G.L.Chapter 148,as provided in Section C�application is hereby made
by
(Full Name of Person,Firm or Corporation) (Phone Number) _.
of a.9 5 Fct she rv-� /Ave- C�Q-- (5-e,-, W 4 0J-150 7
(Address:Street or P.O.Box,City or Town,Zip Code) f_
for permission to(state clearly
purpose for which permit is requested) Gv 2- G 6 11t LP
Name of Competent Operator(if applicable) 'Vert.No.
Date Issued-rejected By
(Signature of Applican)
Date of expiration Fee Amount Paid$
-- —-----------------------------------------------------------------
/
p,�
{
.1o, /4,
FP-006
(Rev.04112) PERMIT
City or Town: / ,:;, c- T7 rl A,l-4 =NUMBERDate: 03 12
Permit Number(if applicable):
In accordan+%with the provisions of M.G.L.Chapter 148,as provided in this permit is granted
to E ±J<51 l L q rnQ('
(� (Full Name of Person,Firm or Corporation)
for 1 - l -0 y,d Le A-c^n
Restrictions: ll
at 12--
(Street and#or Describe Location for Adequate Identification)
Fee Paid$ This per 't will expire on
Signature of Official Granting Permit: r Title r
This permit must be conspicuously posted upon the premises