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HomeMy WebLinkAbout0132810-Storage Tank (remove)OSHKOSH ON THE WATER Job Address 2005 OREGON ST Contractor WD NAVIS INC Tank Type ~ Metal ~ Fiberglass Service ~ Install ~ Remove Contents ^/ Petroleum ^ Kerosene Use/Nature of Work CITY OF OSHKOSH STORAGE TANK PERMIT -APPLICATION AND RECORD Tank Size Tanks Q Above Ground ~ Underground ^ Solvent ^ Natural Gas ^ Liquid Petroleum ^ Other remove underground fuel storage tanks Valuation $4,150.00 Permit Fee Paid $720.00 Issued By: ^ Permit Voided Date 9/11/2008 Parcel Id # 1410110000 In the performance of this work I agree to pertorm all work pursuant to rules governing the described construction. Signature Date Address P.O. BOX 48 Agent/Owner WAUPUN WI 53963 -0 Telephone Number 920-324-8995 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. Category 281 -REMOVE STORAGE TANKS No 132810 Owner CONVENIENCE STORE INVESTMENTS Create Date 9/11/2008 CITY OF OSHKOSH UST,/AST PERMIT CHECKLIST Job Site Address: o~t~Q~ l" 1~r~Pn~n,r"'1 ~- REEIVE® Contractor: SEP 10 2008 Address: Y. DEPARTMENT OF COMMUNITY DEVELOPMENT ES DIVISION Phone # : ~~~'?~~~.~-~bCI~S FAX # : C Cj~ ~ ~c{~ ~ (~ ~ p (~ AST UST Install Remove ~ Upgrade Tanks/Piping Number, Size, & Contents of Tank(s): ~= /` ._ ~ ,~ Tank(s) Composition: Piping Composition: '~ << Approximate Cost of Job: Approximate Start Date : ~ ` ~"'~ 1i7 D Permit Issuance Approval: YES V No Conditions of Approval: Approved by. Date: ~ ~ ~ Tank System Fee: ~ ~ 2 ©Plan Review Fee ~" Permit Fee PLEASE NOTE: THIS IS NOT A PERMIT. To obtain the required permit, present this checklist, along with a check made payable to the "CITY OF OSHKOSH" for the amount listed in "Permit Fee" (above) at the Building Inspection Office, Room 205 at City Hall, between the hours of 7:30-8:30 AM and 12:30-1:30 PM; or by appointment (920) 236-5045. This permit shall be obtained and on-site prior to the commencement of any work.