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HomeMy WebLinkAboutLP storage tank permit - LP Gas Tank - 94 WINDKIST FARM ROAD 10/14/2015 Ck � t6'o�� wl�y t ��Application for Standard Permit FP-006 y Return completed application to: F (Rev.04112) Permit Number: DIG SAFE NUMBER City or Town: V0 C--tLlI Start Date: Date: In accordance with the provisions of M.G.L.Chapter 148,as provided in Section application is hereby made by Alr1ci5 / 6-4VARAO�- CQ) ? ggi I7 --�3 d& (Full Name of Person,Firm or Corporation) (Phone Number) Of a� L ct she-,A Ave-- CPQ-e.(ls�-e-- 0/1 04 15 o (Address:Street or P.O.Box,City or Town,Zip Code) / for permission to(state clearly purpose for which permit is requested) Sin /- qZO �/ �2 0 Cl car u✓ nnek -, c Get ,�' 7-6'7,2 -© 3a k Wia Name of Competent Operator(if applicable) ert_NoAAppliic.a*n) � g Date Issued-rejected By (Signature of Date of expiration Fee Amount Paid$ Y� --�----------------------------------------------------------------- UP 0/ o� !V G FP-006 (Rev.04/12) PERMIT City or Town: ItIc'r f h doye-,/ DIG SAFE NUMBER Date: �d /-/VAT —T z Start Date: Permit Number(if applicable): In accordant with the provisions of M.G.L.Chapter 148,as provided in this permit is granted to Pk t l<5/U pq al o ` (Full Name of Person,Firm or Corporation) for 1 1"YLU LQ/ �20 (71 f _T Restrictions: at V/,—o kt 5:1 (Street and 4 or Describe Location for Adequate Identification) Fee Paid$ 5 v �- This permit will expire on �l! f�r�t✓��/�� Signature of Official Granting Permit: Title This permit must be conspicuously posted upon the premises '