HomeMy WebLinkAbout0154246 - Starage Tank (underground waste oil tank) CITY OF OSHKOSH No 154246
OSHKOSH STORAGE TANK PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 2167 STATE ROAD 44 Owner QUENTIN/MARY GERLACH Create Date 1/23/2013
Contractor WALT'S PETROLEUM Category 281 -REMOVE STORAGE TANKS
Tank Type O Metal • Fiberglass Tank Size Tanks
Service 0 Install • Remove O Above Ground • Underground
Contents ❑ Petroleum ❑ Solvent ❑ Natural Gas
❑ Kerosene ❑ Liquid Petroleum 0 Other
Use/Nature REMOVE(1)2,500 GALLON UNDERGROUD WASTE OIL TANK *'check#26251
of Work
li
Valuation $4,727.00 Permit Fee Paid $100.00
Issued By: Mi Ld Date 1/23/2013
❑ Permit Voided Parcel Id#1329430200
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
Agent/Owner
Address 5207 E JELINEKAVE SCHOFIELD WI 54476 -4233 Telephone Number 715-551-0018
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.
CITY OF OSHKOSH UST/AST PERMIT CHECKLIST
Job Site Address: 2167 State Road 44
Contractor: Walt' s Petroleum
Address: 5207 E Jelinek Ave
Schofield, WI 54476
Phone #: 715-551-0018 FAX #: 920-339-0378
AST UST X
Install Remove X Upgrade Tanks/Piping
Number, Size, & Contents of Tank(s) :
1-2, 500 Gallon Waste Oil Tank
Tank(s) Composition: Fiberglass
Piping Composition: Fiberglass
Cost of Job: $4, 727
Approximate Start Date: 1/28/2013
Permit Issuance Approval: YES X No
Conditions of Approval: Per WI Dept of Safety & Professional
Services—SPS 310
Approved by: John Holland, LPO
Signatu Date: 01/22/2013
Tank System Fee: $100 Plan Review Fee: Permit Fee: $100
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.