HomeMy WebLinkAbout0114826-Storage Tank (install)
e
OSHKOSH
ON THE WATER
CITY OF OSHKOSH
No
114826
STORAGE TANK PERMIT - APPLICATION AND RECORD
Job Address 4300 N SHERMAN RD
Owner STATE OF WISCONSIN
Create Date 6/23/05
Contractor HALRON OIL CO
Category 280 - INSTALL STORAGE TANKS
Tank Type . Metal 0 Fiberglass
Service . Install 0 Remove
Contents D Petroleum
D Kerosene
Tank Size 2700
Tanks
D Solvent
D Liquid Petroleum
. Above Ground 0 Underground
D Natural Gas
D Other
Use/Nature NL /10% Ethanol Install per plans
of Work
$8,085.00
Permit Fee Paid
$135.00
Valuation
Issued By:
Date 6/23/05
U Permit Voided I
Parcelld # 15541 00000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address
0
-0
Telephone Number
--
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
C\ \ .55 '-\ \ ar:s::s:::D
S\""~ ðI'"I->ì
. \'-\"\ "Wll-5'W S í
~fd)":' WI $'"DìO6-
;3'10b
Job Site Address: L\~O6 ¡J, ~~r~ ~~,
Contractor:\-~\-fù <\ c':) I. \ C-ö., -:::c 1"'"\ L
I
Address: \\D \ q ,~~ St '
~ê) ~O^ -z..~~
~(~e(\~ l WI:.
Phone Number{ qù::> ., l\~ ì ::e:>l\- \0 \a
~~\.p - 2\"'1, 'i
Fax Number: (Ot2è:» C>¡,\.,$ -sìQa
AST ,X
Install Tanks
x
Upgrade Tanks
UST
Remove Tanks
Upgrading Piping
Tank Informatio~
#2
#3
#4
#5
~~\
dl C) () ('Ã~,\ë:>,
~l \0"1" ~" \
Pipi~g ~'¡~.[D,^C'\~ . - S-k-e \ .
Approximate Cost of Job: ~ 1 W'1>5
~\~ Co\ml:> S-
Permit Issuance Approval: Yes ¡/ No
Conditions of Approval: ~~ \\~ Vi"í ::" .b~ A\e.¿
~ \"bY\s .
Permit APprove~yA
Tank System Fee tOO Plans Review Fee "bS
Composition
Tank Size
Contents
Approximate Start Date:
Date:-1{ II \ ~ç-
. CC
PERMITFEE: {\~ß-
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 of7:30-8:30 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.
~/¿}(P(J? 5'
ß
I!J /3~'