Permit - Storage Tank

Installation/Removal/Out of Service

Notice*
No permit will be issued until $50.00 fee is recieved. Please make checks or money orders payable to "County of Henry" and send to: Henry County Fire Marshal's Office 1024 DuPont Road Martinsville, Virginia 24112
Type of Storage Tank

Type of Storage Tank Above Ground Below Ground
Scope

Scope Removal Installation Abandon in place
Job Site Address Job Site Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Property Owner Name
Business/Contractor Name
Business/Contractor Address Business/Contractor Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Business/Contractor Phone Number Business/Contractor Phone Number - ### - ### ####
Individual in charge of site
Site Contact Phone Number Site Contact Phone Number - ### - ### ####
Email
Scope of Work
Upload plans/drawings

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