HomeMy WebLinkAbout2013-Storage Tank (install) /�"� CITY OF OSHKOSH No 157054
OSHKOSH STORAGE TANK PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 1090 N WASHBURN ST Owner KWIK TRIP Create Date 8/5/2013
Contractor WALT'S PETROLEUM Category 280-INSTALL STORAGE TANKS
Tank Type � Metal � Fiberglass Tank Size Tanks
Service � Install � Remove � Above Ground � Underground
Contents ❑ Petroleum � Solvent � Natural Gas
❑ Kerosene � Liquid Petroleum �✓ Other
--- —__ ;
Use/Nature KWIK TRIP/INSTALL 6 UNDERGROUND STORAGE TANKS(DW STEEL-FIBERGLASS REINFORCED PLASTIC COMPOSITE,DW
of Work FLEXIBLE)TO INCLUDE THE FOLLOWING(1)9'X24'-20K-UL, (1)8'X40'-15K-UL,(1)9'X21'-10K-UL,(1)9'X21'-10K-E85, (1)
'X21"-10K-DIESEL,(1)9'X21'-10K-DIESEL "'check#27853
-- ---- --
Valuation $390,000.00 Permit Fee Paid $300.00
Issued By: �)')')j� Date 8/5/2013
❑ Permit Voided I Parcel Id#
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: �v�K ra�P � �2 IcAo N I�ashbvrn Sfi
N• �,�/�s�taw� � Nwy 21
Contractor: vsNKdsN, w►� 5�9�� �2ECEI�ED
1�/�+-rS VtrRv�E�M StRvr�f,�,u�, ;-
Address: s2v� E. JE�+�tK �vE. I
St,.NVFfC�p� �� s���� JUL 2 6 2013
Phone #:7►r 3sy�3�2F� #: y��-3S5-�13i DEP.�RT�3'£!i o�
CO>7�tU�YT1r'`?E��E�OP�IEVT
AST UST iVSPECT70�S'�R�'10ES Dl�'ISIOv
Install Remove Upgrade Tanks/Piping
Number, Size, & Contents of Tank(s) :
q'rdz' -2oK - ul� 9'x2�' -IOK- FB,f
. � �
$ r4o �SK - KL q'xZ�' -IvK -��ass�
q�K�'. IDK - �+1 !► C����. �/OK' D�ESE�
Tank(s) Composition:
D� s reEL-F�6FR�,c�►ss R t w Fe�o P�*�� CoMr�,rE
Piping Composition:
Dw FLEY�&E
Cost of Job:
d�3qp�W��
Approximate Start Date:
stPr lb. 2oi3
Permit Issuance Approval: YES No
Conditions of Approval: Per WI Dept of Safety & Professional
Services-SPS 310
Approved by: John Ho land, LPO
Signature: Date:
Tank System Fee: Plan Review Fee: Permit Fee:
,�3� - .
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.