Permit Information
Permit Information
| Is this application for a New or Existing Permit (Renewal)? |
Existing
|
Existing Permit
| Facility Name |
(Area Y) MELLOW MUSHROOM PIZZA
|
| Facility Contact Phone Number |
404-509-1435
|
| Facility Contact Name |
SHELLEY SINGER
|
| Existing Facility Permit Number |
897
|
| Facility Mailing Address |
470 TROWGATE LANE, ATLANTA GA 30350
|
| Facility Address |
6100 ROSWELL ROAD (MAILING ADDRESS) SANDY SPRINGS GA 30328
|
| SwiftComply Establishment Profile URL |
https://fulton-county-ga.swiftcomply.com/city/establishments/725
|
| Has anything changed since last year? (Enter N/A or no if no changes to owner, systems, etc.) |
NO
|
Owner / Corporate Information
| Owner / Corporation Name |
Mellow Mushroom
|
| Owner Contact Name |
Michel Panos
|
| Owner Contact Telephone |
---
|
| Owner Address |
---
|
Certification
Certification
| Full Name |
Michel Panos
|
| Certification |
Yes
|
Verification & Permit Fee Calculation
Fee Calculation
| How many subsurface system (exterior) tanks does the facility have? |
1-5 ($250)
|
| How many Manual (interior) 10-100 pound units does the facility have? |
0
|
| How many Automatic Grease Recovery 20-35 GPM units does the facility have? |
0
|
| Is the payment for the current year permit considered late? (RENEWALS ONLY: If today's date is prior to May 31, 2024, the answer should be no. If today's date is after May 31, 2023 the answer should be yes) |
Yes (25% late fee will apply)
|
| Please enter how many years permit has been unpaid in the past (please enter 0 for none) (RENEWALS ONLY): |
1
|
| Notes |
|
