HomeMy WebLinkAbout2004- Storage Tank (install)OSHKOSH
CITY OF OSHKOSH
STORAGE TANK PERMIT - APPLICATION AND RECORD
Owner MILLS PROPERTIES INC
Category 280 - INSTALL STORAGE TANKS
No
[] Solvent
[] Liquid Petroleum
ON THE WATER
JobAddress 177 N WASHBURN ST
Contractor OIL EQUIPMENT COMPANY INC
Tank Type ~ Metal ~ Fiberglass
Service O Install ~ Remove
Contents [] Petroleum
] Kerosene
Create Date 10/5/04
110902
Tank Size 1000 Tanks 1
Above Ground O Underground
[] Natural Gas
[] Other
Use/Nature
of Work
one 1700 G waste oil storage tank.
Valuation
Issued By:
$1,700.00 Permit Fee Paid $100.00
Permit Voided
Date 10/5/04
Parcel Id # 0614000000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 1140 ASHWAUBENON GREEN BAY WI 54304 - 0 Telephone Number 920-336-9116
Inspection (i.e. Footing, Service, Final, etc.), Access into Building if Secure (how do we gain entry), your Name and Phone
Number. Unless specified otherwise, we will assume the project is ready at the time the request is received. Work may
continue if the inspection is not performed within two business days from the time the project is ready.
While the City of Oshkosh has no authority to enforce easement restrictions of which it is not a party, if you perform the work
described in this permit application within an easement, the City strongly urges the permit applicant to contact the
easement holder(s) and to secure any necessary approvals before starting such activity.
8:14 FAX
Job Site Address:
UST/AST PERMIT CHECKLIST
001/001
Contractor:
Address:_..
Phone Number: ~/-a -' ,,?;~ 6' - ~/.l t~ Fax Number:
AST Install Tanks ~/'~Upgrade Tanks
UST / Remove Tanks Upgrading Piping
Tank Information
#2 #3 #4 #5
Composition
Tank Size
Contents {aa4~- a t
Approximate Cost of Job:
Approximate Sma Dam:
Perm{t Issu~ce Approval:
Conditions of Approval:
Permit Approved by:
Tank System Fee ,/t))) ~
Z.---,,.~ () - ,
Plans ReviLe, Fee -
'PERMIT FEE:
Note: This is not a permit. To obtain the required permit, present THIS CHECKLIST, along with a SITE PLAN a~
a CHECK made payable to the "CITY OF OSHKOSH" for the amount listed in PERMIT FEE, to the Building
Inspectors Office, Room 205 at City Hall, between the hours el 7:30-8:30 a,m. and 12:304:30 p.m. or by
appointment (920) 236-5045. This City Permit shall be obtained an~f on site prior to commencement of work.