HomeMy WebLinkAbout0101916-Storage Tank (removal)OSHKOSH
ON THE WATER
,Job Address 820 W NEW YORKAVE
Contractor FOUST EXCAVATING
Tank Type O Metal (~ Fiberglass
Service (~) Install O Remove
Contents [] Petroleum
] Kerosene
CITY OF OSHKOSH
STORAGE TANK PERMIT - APPLICATION AND RECORD
Owner JERRYJ NAULT
Category 281 - REMOVE STORAGE TANKS
Tank Size 1000
~) Above Ground
[] Solvent [] Natural Gas
[] Liquid Petroleum [] Other
No 101916
Create Date 6/3/03
Tanks
Underground
Use/Nature :~emove one -1000 G UG fuel oil storage tank.
of Work
Valuation
Issued By:
$1,500.00 Permit Fee Paid
$100.00
Date 6/3/03
Permit Voided
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
Signature
Date
Agent/Owner
Address 820 W NEW YORKAVE OSHKOSH WI 54901 - 3640 Telephone Number
OSHKOSH
ON THE WATER
Job Address 820 W NEW YORK AVE
Contractor FOUST EXCAVATING
Tank Type · Metal ~) Fiberglass
Service (~ Install · Remove
Contents [] Petroleum
] Kerosene
CITY OF OSHKOSH
STORAGE TANK PERMIT - APPLICATION AND RECORD
Owner JERRY J NAULT
Category 261 - REMOVE STORAGE TANKS
Tank Size 1000
[] Solvent
[] Liquid Petroleum
No 101916
Create Date 6/3/03
Tanks
Above Ground · Underground
[] Natural Gas
[] Other
Use/Nature ~emove one -1000 G UG fuel oil storage bank.
of Work
Valuation $1,500.00
Issued By:
Permit Fee Paid $100.00
Date 6/3/03
In the performance ~f t~is work I agl~ee,~o pe~oF~ ~ w.~ules governing
Signature (~~/~~A~enFOwner
Address 82~EW YO~AVE OSHKOSH
the described construction.
WI 54901 -3640 Telephone Number
0BL02/2003 M0N 13:39 FAX 001/001
UST/AST PERMIT CHECKLIST
Address:
Phone Number:
Fax Number:
AST Install Tanks Upgrade Tanks
UST I~ Remove Tanks ~ Upgrading Piping~
Tank Information #I #2 fi3 #4 #$
Composition
Tank Size --~
Contents
Piping
Approximate Cost of Job: .~_~
Approximate Start Date: ,._7-tz~O (~
Pemfit Issuance Approval: Yes,,
Conditions of Approvah
No
PERMIT FEE:
Note: This is not a permit. To obtain the required permit, present THIS CHECKLIST. along with a SITE PLAN ant:
a CHECK made payable to the "CITY OF OSHKOSH" for the amount listed in PEKMIT FEE, to the Buildiug
Inspectors Office, Room 905 at City Hall. between the hours of 7:30-8:30 a.m. and 12:30-1:30 pm. or by
appointment (920) 236-5045. This City Permit shall bo obtained and on site prior to commencement of work.