HomeMy WebLinkAbout0112708-Storage Tank
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OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
112708
STORAGE TANK PERMIT - APPLICATION AND RECORD
Job Address 2601 S OAKWOOD RD
Owner WilLIAM/CLAIRE DOUGHERTY
Create Date 2/18/05
Contractor Oil EQUIPMENT COMPANY INC
Category 280 - INSTAll STORAGE TANKS
Tank Type . Metal 0 Fiberglass
Service . Install 0 Remove
Contents 0 Petroleum
D Kerosene
Tank Size 340
Tanks
D Solvent
D Liquid Petroleum
. Above Ground 0 Underground
D Natural Gas
D Other
Use/Nature IND/ Install 340 gal AST for Waste Oil as per plans approved by OFD. (2615 S Oakwood Rd)
of Work
$1,000.00
Permit Fee Paid
$135.00
Valuation
Issued By:
Date 2/18/05
U Permit Voided I
Parcelld # 1329110100
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.
e
OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
112708
STORAGE TANK PERMIT - APPLICATION AND RECORD
Job Address 2601 S OAKWOOD RD
Owner WilLIAM/CLAIRE DOUGHERTY
Create Date 2/18/05
Contractor Oil EQUIPMENT COMPANY INC
Category 280 - INSTAll STORAGE TANKS
Tank Type . Metal 0 Fiberglass
Service . Install 0 Remove
Contents 0 Petroleum
D Kerosene
Tank Size 340
Tanks
D Solvent
D Liquid Petroleum
. Above Ground 0 Underground
D Natural Gas
D Other
Use/Nature IND/ Install 340 gal AST for Waste Oil as per plans approved by OFD.
of Work
$1,000.00
Permit Fee Paid
$135.00
Valuation
Issued By:
Date 2/18/05
U Permit Voided I
Parcelld # 1329110100
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.
UST/AST PERMIT CHECKLIST
Job Site Address:
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Address: \ :::L ~::, '" LÒ-e.:s.+ Cc", -\.e J ~~ -
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Phone Number:«(Dl> )Î32. - :5 ¡"""Il..
Fax Number: (2..Is>2) "lo"D - "I3<¿í'i?
AST
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Upgrade Tanks
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Remove Tanks
Upgrading Piping
Tank Information@
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Composition
Tank Size
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Contents
Piping
Approximate Cost of Job:
Approximate Start Date:
Permit Issuance Approval:
Yes
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No
Conditions of Approval:
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Tank System Fee \ D D
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PERMIT FEE: , \~Ç
Note: This is not a permit. To obtain the required permit, present THIS CHECKLIST, along with a SITE PLAN an<
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 of 7:30-8:30 a.m. and 12:30-1 :30 p.m. or by
appointment (920) 236-5045. This City Permit shall be obtained and on site prior to commencement of work.
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