Laserfiche WebLink
w1r11� J1JHwUaW Lul-HL rYCNLIfY uaa9lKax: � <br /> 7NDERGROUNO STORAGE TANK PROGRAM - FEE YORK T 54 <br /> Fh'A 6LITY/SITE NAME FACILITY CONTACT NAME <br /> STREETADDRESS C 0 SI HONE I (with Area Code) <br /> T �U <br /> Y CITY TE IIP CODE 1 of TANKIS <br /> Y4 2j at Site <br /> PA APPLICANT/BILLING NAME APPLICANT CONTACT NAME <br /> P <br /> L <br /> C <br /> A41 S MAILING ADDRESS AP I fNT PHON 1 (with Area Cods <br /> N CITYSTATE IIP CODE TYP f APPLICATION <br /> J osur , Installation, e <br /> A <br /> FACILITY FEE = 1100.00 each SITE ADDRESS per YEAR TOTAL <br /> T 1986 1987 1988 1989 <br /> I s <br /> V <br /> E TANK FEE = $50.00 each TANK <br /> F 1 Tanks _ x 150.00 1986 1987 1988 1989 <br /> A ti tipTy-1-by fee for <br /> I uch year applicable) f <br /> 1 STATE SURCHARGE a $56.00 each TANK (sae CA HEALTH k SAFETY CODE Sec 25287 for applicability) <br /> T 1 Tanks x $56,00 1986 1987 1988 1989 <br /> Y (Inter iiHA and year) <br /> 1 <br /> C PERMANENT CLOSURE (Removal or Closure-in-place) <br /> L <br /> 0 CLOSURE FEE = $90.00 each TANK 1 Tanks-.�-- x $90.00 s <br /> U <br /> R TEMPORARY CLOSURE (Only allowed one time for up to two years) <br /> E <br /> TEMPORARY CLOSURE FEE a $80.00 each TANK 1 Tanks--.._ x $80.00 t <br /> P PLAN CHECK (Installation or Repair) <br /> L <br /> A <br /> k PLA$ CHECK FEE $30.00 each SUBMISSION/P,E5UBMISSION s <br /> R REPAIR <br /> E TANK REPAIR FEE • $110,00 each TANX I Tanks x $110.00 $ <br /> A <br /> I PIPING RFPATRICLOSURE/REMOVAL (Fees are per hour, minimum one hour to be paid on plan submittal) <br /> R <br /> UNAUTHORIZED RELEASE EVALUATION CONSTRUCTION a ,. SAMPLING <br /> (when applicable) INSPECTION INSPECTION <br /> FEE a $30.00/hr FEE _ $35.0011hr FEf $35,00/hri s <br /> TOTAL DUE $ <br /> OFFICE USE ONLY <br /> i <br /> BWEEPS 1 COMP 1 LOC CODE DIRT CODE I AMOUNT DUE I AMOUNT RCVD CHECK 1/CASH RCUQ BY DATE RECEIVED PERMIT 1 <br />