HomeMy WebLinkAbout0158696-Storage Tank (install) � CITY OF OSHKOSH No 158696
OSHKOSH STORAGE TANK PERMIT -APPLICATION AND RECORD
ON THE WATER
Job Address 100 COURT ST Owner OSHKOSH HOUSING AUTHORITY Create Date 8/21/2013
Contractor U.S.PETROLEUM&EQUIPMENT Category 280-INSTALL STORAGE TANKS
Tank Type � Metal � Fiberglass Tank Size 600 Tanks
Service � Install � Remove � Above Ground 0 Underground
Contents ❑ Petroleum � Solvent ❑ Natural Gas
❑ Kerosene � Liquid Petroleum ❑✓ Other
Use/Nature INSTALL(1)600 GALLON DIESEL DBL WALL STELL SUB BASE GENERATOR TANK-ENGINE SUPPLY&RETURN HOSE
of Work ONNECTIONS "check#4726
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Valuation $1,250.00 Permit Fee Paid $160.00
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Issued By: ��� Date 11/11/2013
❑ Permit Voided I Parcel Id#0800340000
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature Date
AgenUOwner
Address 558 CARTER CT KIMBERLY WI 54136 -2200 Telephone Number (920)735-8287
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.
Hug. lb. ZU13 1U:46AM Oshkosh Fire Dept No, 4271 P. 2
, CITY OF OSHKOSH UST/AST PERMIT CHECKLIST
JOb S�te AddreSs; 100 COURT S�REET ( OSHKOSH COURT TOPTER3 )
Contractor: �.5. PETROLEUM EQUIPMENT
Addzees: 558 CARTER CO�RT
KIMBERLY, WY. 54136
Phone #: 920-735-8287 FAX #: 920-739�0741
AST X US�
Iastal� X Remove Upgrade Ta�ks/Piping
Number, 3ize, & Content� of �ank(s) :
1 600 GALLONS DIESE�•
Tank(s) Composi�ion: DBL WALL STEEL SUB BASE GENERATOR TANK
Pipinq Composition: �NGZNE SUPPLY & RETURN HOSE CON�ECTrON5
Cost of Job; $1, 250, 00
Approximate 9tart Date: AUG 2013
Permit Iasuance Approv�l; YES No
Conditiona of Appreval: Per WI Dept o� Aqriculture, Trade &
Consumez Protection — SPS 310
Approved by: John Hol and, �PO
Signatux : � Date: � I �,�` � �
Tank 9ystem Fee; �Q� Plan Review Feec � Permit Feer�1 ��
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PLEA3E NOTE: THIS IS NOT A PERMIT. To Obtain the requi�ed
permit, present �his checklist, al.ong with a check made payable
'CO the "CITY OF OSHTCOSH" for the amoun'� listed in "Permit Fee"
(abo've') at the Building Inspection Office, Room 205 at Ci�y Hall,
between the hours of 7:30-6;30 AM and 12:30-].;30 PM; or by
appointment (920) 236-5045. Th1,s permit shall be obtained and
on-site prior to the aommencement of any work.