PERMFILE40232

• Permit No: M2000032
• IBM Index Class Name: Permit File
• Doc Date: 3/2/2000
• Doc Name: SALES RECEIPT
• From: DMG
• To: MA CONCRETE CONSTRUCTION INC
• Media Type: D
• Archive: No

C:
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• Id. Correaoondeece Intormatioe:
APPLICANT/OPERATOR (name, address. and phone of name to be used on petimt)
Contac['sName: ~A12T1~4 I~LSAR$sa.GA Title: ~WNCsSt/
Company Name: N~1•A• ~~Gtt-ETb

street. 2323 piIV~R. ROAD
city: _ Gp-Ah4AJUlJG'[tC)t-~
State: ~-0 LSO Zip Code: ~i 54 5
Telephone Number: (°170 l _ 243 - 322.1

Fax Number: (~lTb ~- 2q-3' 9'15

PER[viITTING CONTACT (if diSerrnl from applicanUoperator above)
Contact's Name: - SAh+ITo .RS At'JbY'E ~' Title:
Company Name'.

Street
City:
Slate:
Telephone Nt®ber.
Fax Number:
• INSPECTION CONTACT
Contact's Natee:
Company Name:
Street:
Zip Code:
- SAME AS AOOI~e. - Title:
Ciry:
State:
Telephone Number: ( 1-
Fax Number: ( 1-
CC: STATE OR FEDERAL LANDOWNER (if anvl
Agency: N D f-I ~r
Street:
City
State: Zip Code:
Telephone Number: ! 1-
CC STATE OR FEDERAL LANDOWNERlif and
Agency: M O H ~'•
Street.
City:
• State:
Zip Code:
Zip Code:
Telephone Number: { 1-