Fillable FOG WASTEWATER DISCHARGE PERMIT APPLICATION (City of Wichita)

Fill Online, Printable, Fillable, Blank FOG WASTEWATER DISCHARGE PERMIT APPLICATION (City of Wichita) Form

Use Fill to complete blank online CITY OF WICHITA (KS) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

FOG WASTEWATER DISCHARGE PERMIT APPLICATION (City of Wichita)

On average this form takes 10 minutes to complete

The FOG WASTEWATER DISCHARGE PERMIT APPLICATION (City of Wichita) form is 1 page long and contains:

  • 1 signature
  • 8 check-boxes
  • 31 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Wichita

BROWSE CITY OF WICHITA (KS) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
FOG WASTEWATER DISCHARGE PERMIT APPLICATION
FATS, OILS, AND GREASE CONTROL PROGRAM
Dept. of Public Works &Utilities, Sewage Treatment Division
2305 E 57
TH
ST S, Wichita, Kansas 67216
Phone (316) 303-8700 Fax: (316) 858-7500
E-Mail: FOG@wichita.gov Web: www.wichita.gov
Rev 3/8/18
DATE: _________________
TYPE OF APPLICATION: NEW PERMIT PERMIT RENEWAL NUMBER: ________________
NAME OF FACILITY: __________________________________________________________ PHONE: _____________________
FACILITY ADDRESS: ___________________________________________________________________ ZIP: ________________
NAME OF BUSINESS OWNER: ________________________________________________________________________________
BUSINESS OWNER ADDRESS: ________________________________________________________________________________
CITY: ___________________________________________________ ZIP: _________________________________
PHONE: __________________________________ EMAIL: _________________________________________________________
OWNER OF BUILDING/LANDLORD: __________________________________________________________________________
OWNER OF BUILDING/LANDLORD ADDRESS: _________________________________________________________________
CITY: ___________________________________________________ ZIP: _________________________________
PHONE: __________________________________ EMAIL: ________________________________________________________
APPLICATION SUBMITTED BY: ______________________________________________ PHONE: ________________________
WATER UTILITY INFORMATION:
ACCOUNT NUMBER: __________________ - _____________________ PAID BY LANDLORD: YES NO
GREASE REMOVAL DEVICE (GRD):
UNDERGROUND INTERCEPTOR WHAT SIZE? (IF KNOWN)___________________GALLON
AUTOMATIC GRD* WHAT BRAND? (Example: Thermaco Big Dipper)_________________________________________
NONE* OTHER* _____________________________
* IF NO OUTSIDE UNDERGROUND INTERCEPTOR INSTALLED, NEED TO APPLY FOR A GREASE VARIANCE
SUBMITTED BY: ________________________________________ SIGNATURE: _______________________________________
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

FOG WASTEWATER DISCHARGE PERMIT APPLICATION (City of Wichita)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 22 March 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document