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* Required Field

Business Information

Business Physical Address

Business Mailing Address Same as Above? *

Business Mailing Address

Business Owner's Name:

Salutation *
Does the business owner own the property/building? *

Property Owner's Name

Property Owner's Mailing Address

Is this business designated as a corporation? *

Corporation Information:

Corporation Mailing Address:

To which address should program information and official correspondence be mailed? *

Non-compliant notices and other program information may also be sent to the property owner at KUB's discretion.

Facility Information

Specify each day, i.e. M-TR 8a to 10p, FR and SA 10a to 12a, SU Closed

Which of the following will be prepared or served at this facility? (Mark all that apply) *
What is this facility's seating capacity? *

How many of each of the following types of equipment are or will be installed at this facility (not including the restrooms)?

Enter a zero if none:

Will a dishwasher be used within this facility? *

Provide the following information for each dishwasher

Do any of the following describe the primary operations of this facility? *
  • A restaurant that prepares meals
  • A cafeteria/buffet
  • A school
  • A food production facility
  • A grocery store deli
  • A bar with a food menu
Will this facility only serve pre-packaged food that is prepared and cooked at a different facility? *
Will this facility only serve food on disposable packaging with disposable utensils? *
Will this facility only serve frozen, cold, room temperature, warmed, toasted and/or catered in food? If cooking or frying will occur on-site, answer No. *
Will this facility prepare or serve food that is cooked or fried on-site? *
Will this facility only offer delivery and/or take out service and there is no dine-in or dine-on premises seating? *
Are any chemical or biological additives used on a constant, regular, or scheduled-basis (excluding dishwashing soaps/detergents)? *
Does this facility have an existing grease trap and/or interceptor? *

Grease Control Equipment

Provide the following for each piece of existing grease control equipment:

Equipment #1: Capacity Units
Equipment #2: Capacity Units

Application Submittal

By checking this box and submitting this application form, I certify that I am, or have been authorized by the business and/or property owner, to sign this document and acknowledge that I have read KUB's Grease Control Program. I also understand that if the facility is remodeled or there is a change in ownership of the business, I must immediately submit to KUB in writing such changes or possibly be in violation of my Grease Control Permit, which is nontransferable. I am aware that there are penalties for submitting false information, including the possibility of enforcement actions in accordance with KUB's Rules and Regulations for the Wastewater Division, KUB's Grease Control Program and its associated Enforcement Response Guide.
My electronic signature above indicates that I am the person responsible for ensuring that the business listed on this Grease Control Permit Application is compliant with KUB's Rules and Regulations for the Wastewater Division and KUB's Grease Control Program. I agree that the business listed on this Grease Control Permit Application will abide by all applicable provisions of KUB's Rules and Regulations for the Wastewater Division and understand that failure to do so may cause disconnection of water service or other enforcement actions in accordance with the Grease Control Program Enforcement Response Guide. I also understand that I am responsible for the grease control equipment and meeting the requirements of the Grease Control Program, even if I do not own the property.
NOTICE: Failure of the responsible party for the business listed on this Grease Control Permit Application to sign this application does not relieve the business from any compliance requirements of KUB's Rules and Regulations for the Wastewater Division or KUB's Grease Control Program.