HomeMy WebLinkAbout0126373-Storage Tank (waste oil)
~. \
~
OSHKOSH
ON THE WATER
Job Address 906 OHIO ST
Contractor BLACK GOLD ENVIRONMENTAL
CITY OF OSHKOSH
No
126373
STORAGE TANK PERMIT - APPLICATION AND RECORD
Owner DONALD E BASLER REV TRUST
Category 280 -INSTALL STORAGE TANKS
Create Date 8/21/2007
Tank Type 0 Metal
o Fiberglass
Tank Size 250
Tanks
Service . Install 0 Remove
Contents [!:J Petroleum
o Kerosene
o Solvent
o Liquid Petroleum
. Above Ground 0 Underground
o Natural Gas
o Other
Use/Nature Install a 250 G waste oil tank inside of building.
of Work
Valuation ~
Issued By:
Permit Fee Paid
$160.00
Date 8/21/2007
o Permit Voided I
Parcelld # 1300020000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Address
101 SPRING ST
Agent/Owner
OGDENSBURG WI 54962 - 0
Telephone Number 920-244-7488
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.
'"
FLAMMABLE AND COMBUSTIBLE MATERIAL STORAGE TANK REVIEW CHECKLIST
Address of Job Si te C\Olo 0\r\.-, b &-\--
Owner 'V(')('"\'~~\er
contractor'~\c. r _L ~...,J.~ -En \J \. ro.t' f'V\e.(\ t-~ \
\~2#~~h~~, ~
RECEIVED
...
AUG 20 2007
Contractor Address
DEPAR llvlcl~ I OF .
COMMUNITY DEVELOPMENT
.5'-\4 ~ ~SP[CTION SeRVICE::; DIVISION
Contractor Phone (C\"2.D ') 2.44- --'4:-~~
Install Tanks~~ Remove Tanks____
Underground
Above Ground
\ - dS()-e~b'l'.. W;.:,~ C5"~~t
~~ 6~ \
Number and Size of Tanks
List Materials Stored
Tank Composition (Check the proper
Fiberglass____ Steel~
Proposed Start Date ~C1
Cost Of Job ~I&(~S
Permi t Fees to be Collected ~t~o
Categories)
Fiberglass Coated Steel
Review Approved For Permit Issuance
~/
Y_ N_
Conditions of Approval:
NOTE: THIS IS NOT A PERMIT. THIS FORM MUST BE PRESENTED TO THE
INSPECTORS IN ROOM 205, CITY HALL, BETWEEN THE HOURS OF 8 - 9 A.M.
OR 1 - 2 P.M. TO OBTAIN THE REQUIRED PERMITS. PERMITS SHALL BE
OBT~INED PRIOR TO COMMENCING ~.TIV T~D ON THIS FORM.
Signature of Reviewing Officer
~\:l-0l0\ ~
Date
STORTANK