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HomeMy WebLinkAboutASB07-0007 PRJ06-0225.pdf APPLI TION WILL NOT BE ACCEPTED IF INCOMPLETE OR UNS� ��s� Project #: ����� � ` ' Building Permit#: � � Asbestos Permit#: '7 � u � '� TOWN OF VAIL ASBESTOS ABATEMENT PERMIT APPLICATION �WN�FYAI� Required per Ordinance No. 19, Series of 1998 75 S. Frontage Rd. Permit application will not be accepted without the following: Vail, Colorado 81657 1. Copies of General Abatement Certificate and State of Colorado Certification 2. A copy of written arrangements with the facility operators for any temporary disabling of the air handling systems, fire sprinkler system, and alarm systems with the names and contact phone numbers of these individuals. 3. Site plan with details addressing: waste container storage location. waste load out area location. entry and exiting details of abatement area. details of entry and exiting plans for the occupants of the structure in unaffected areas. CONTRACTOR INFORMATION On Site Abatement Contractor: Town of Vail Reg. No.: Contact and Phone #'s: AMERIC�'N ABA'I'E��[�I'I', INC. 483-5 Office: 303-298-8550 E-Mail Address: elaine@amer' anabatement.com -jo@americanabatement.cam Contractor Signature: � .�': "�- Jim Oleskevich (V�') Cell: 303-472-0262 i' � °� � �� COMPLETE VAL[JATI�N FOR ASBESTOS ABATEMENT PERMIT (Labor & Materials) Asbesto�Abatement: $ �, �-a � •�'L� Contact Ea /e Coun As�essors O�ce at 3���,3 6 or visit www,ea /e-coun ,com for Parce/# ParCel # 21010630�024 ;�� -< � `�r_ . Job Name: ���y, John & Vera ' ���.���~ � 7 ato Patch Rd. , Vail, CO Legal Description Lot: 24 Block: 1 Filing: �- Sull�9ivision: Vail Potato Patch Owners Name: ���,,�Ay Address: 400 Mansfie d Phone: 970-476-7124 Project Manager: Address: �'len, CT 068 _ Phone: Project Designer: Address: Phone: Air Monitoring Specialist:��N �����c Address: �� �°x I z3c� Phone: .��#c� a�s��-,-,�; -T��r�U �`it=roFJ . GU Y�i�2u it�,� 97� _ Z7U -.,w�'>y� Detaileddescriptionofwork: �,����a.u- A FuLL c��;�a��,MENr 7�y,cM �,,T�.� ��,�.�,.;�c,��-��, �c���;��s �w� �i��t�:�,� � C;vit.��. ti- cj �S `�4. �� f.�(- Li'�JUL.�e.IAR F�OM W eT(-l:Al �+'f-�T 1=r.(�'�1cL�L: �ilC,is-I., ,L :� (,� f:U e 1.1- l>C9 1 f�Vt�L�� �17J7 �+c:N 0�1= cJ,'.i ��{-Pc= DC,MI:ULLT(Otii �'��'-M1 � r����1Ct+.Tln`� J'.7 :5c`atsl�F- a�i= 77-(rOl:J�tiE! Start Date: �E._q _�,-J End Date: �-1 Z-�°7 Start Time: �_ao,an� Quit Time: :��� ;� Pt�1 Amount of Asbestos: Linear Feet: �— Square Feet: �-� 55/Gal Drums: --- Work Class: New ( ) Addition ( ) Remodel ( ) Repair ( ) Demo (�' Other( ) Work Type: Interior (✓� Exterior( ) Both ( ) T e of Bld .: Sin le-famil � Two-famil Multi-famil Commercial Restaurant Other Does a Fire Alarm Exist: Yes O No ( �)' Does a Fire Sprinkler System Exist: Yes O No (� *���**�***����������:��:�**���*��*�����**FOR OFFICE US� ONLY��*��������*xx��.��x:�*�r*���:��*:�*����:�*� � � Other Fees: Date Recei�ed: ' ��� Public Wa Permit Fee: Acce ted B : �- �� r Q.� Occu an Grou : F . �, ��, ���, _ ,, F:\cdev\FORMS\PERMITS\Fire\asbestos�errti_12-5-05.DOC 2� � Page 1 of 1 12/05/2005 1- � �1 .1 _l-� d� �A `� 1� �_ �; � �7�� ��� �. �� � �; � , y �.y: x„r _ . : z-.< . . 1. r :. /� '�` J 4 � i. �.�...L/- �E`„e� ��. Fn. -p...� �!„:`..� . "�.�eR_< 4..-�r ��� �. E,... f ��-4.✓`� F— (✓��-� {.�.i��....»�� f'`. ✓ �:<, �_ �`( :� ,�'� �"� �:: �'-��l„%!�. � ._. (.�.�.�„�,��..� S r� (<:�j �TiLi�j � .; l� .. C' _ %'t —F - � � �, . r C ��t t�� L i i r?�.1 T��.-�F��� � �- -- I Zr -- �j � � N�� � Y � � k' ? `; ro � % "���7t� �"��:� � � e� ��� d'�}:' ;:.,�. ,��m. � __ _ ..---.. �. .___ _____ _,_ _ �_, .__ _ __. � i !a✓,r�� -( i . t�_ (.t _� _>___� _._ �. _ ._. .. � G--�_[__�'� i � -- �' ?; �7,�._Cs�c- T� � `.. � r t (�_/� t � i f�-k�°> � rs Q � 1�1 (T"� � �nlL1 r,.�°i " (�� '� -�C.��. f.= � t" 1 t"? t � t-t E f'� C= C� f� � — i � _.__._._. ( , ^'j� � � �.���' �p I < < � .�. 6� �`•.e�i� ��` f:'( ET& i � , .�_� _ � �'lE4+s E�'t� i �" � /�/1 � � �_°� w i f� "1 ft. i a!_ a! f, f 'fi'f:: �Fa r ,-i �` �`�` f�t `E E,-_� (�'f /��7-t�_ r>?� L' E: � � 4 e..� G.� j f �� (�:t?�7�f ' f !� r. ' � . �— P ::': ��{ E�\.� 5.: 1�-- .rz {�t.t � � �' �- � � ..... ". a ��.�' v_=...£fi'��. 7 f-..� j-`' �.i., ei � '' 4 I ��. i _ " � ` � � {1 ( i 1l � � 3r � Y 1 �Ci`�f�- g i C: c� F�I"�"d'e t !.2 �_`�� � S T� L? �. C� E' �k L-of d�'T�e�.=;'�.-i' E �� L.. h ! C`"( -.�4� F,; G� ;,C a, �.: f l$FE I� ���L.� �`-$'�.. � �'� P� � � � r.� G7�� �� ��`� --� � � � � � � ! e ot�s-r-F��.C�-��� � �, f�� � � �_t� �.� � f'= ��� � h�e �-: �� , � r�� �:. , �-� �.-t� � f�C�,� �.3 C� �' �� t�l �(�`� �, �>�� �J E`� �. E �w ��� �- � � � m., � �-���� �� s t -�- r- � �� ���:: �-��'t � � � � �r� �� r��f �� �r� i �- � 3 t� � � �- '7 2 �-- � � 4--�� G or�r s c.c �_�� r�`� � /-� � � � � 1� � �;�� � ;, °°�`�:'��"�� �4 � � CO r�i � €� �`�" � f�c� -�O d�d �E �`��`�-`���,,�:� ; ; 9 � � - z7 � - 3 � � � ; • � ; ' O�' C�lpA � "� °�° "�°' � � � "� � Submitformto� Permif Coordinator � �,� � '�',y� Colorado Dept. of Public Health �"C ,`����,� O � � � �� � � � � � � and Environment � � Q � APCD-SS-B1 �, � � ��,� �3? ,� � F� � � UST ��GQ �vt (�,q (V� �INI .� �ORM . asoo cner�, c�eek o���e s��,fn `� -� "` ;::=,�/ � ; INC>OMPL. ETE A, P � I_ IG�OTICJC� � V�IILI... BE R.�TUR� ED . Denver, C080246- 1530 � � � � Phone: 303-692-3100 � 7g76!' Permit will be mailed to abatement contractor unless s ecified otherwise -- � p � Fax: 303-7II2-0278 E��rr� i� �°��5� �; 34�-L��y 9aw��� � r� �:m`� �ar l� �fi �� C� nly � � ra¢�s��r ; �er�ar�e� y �4atiice ___ ---_ __---- _ _- --- _---- � ___ _ __ _ __ _ _ __ __ �__ ___ i _ ___ _ ._ _ _ � _ _ - _ _— Singie-Family Residential Dweiling ONLY ± � i � ' � __ _ T _ --- __ . - i � � > 50 Lf= oi 32 Sf= oi a 55-gal. drum, but � ; � '� 6� ��,� � ���� � �� $Q (} � ! � � ��� _< 260 L� or 160 Sf= or a 55 gal . drum ! ' � ; � � o a _ _ _---- - ---- - -- ---- �- _ �-- -____ � ___ , -- � Okay 4 F x __ _ - � -- �-- -'- --- � Public & Commercial, 5chool, and Single- � i I � ; I 1-- - - Family Residential Dwelling Building , j � � � ��� _ � $275 $ s�Q ��25 � $J5 I �4�l� � >260 LF or 160 SF or a 55-gal. drum ' ! i i I i Okay fo Fax i Company Name ; Buiiding Name � I �1vIERICAN t�BATEIVIENT, INC. �4.I �` �7-E@40� RI:SIIILNCE FOR DEMOLITION _ - _ _ __ ___---- - __ - -------- -----__. --- - __ _- __ _ --- _ _ __ _ c� , _ . f� � Street � � f �„ � � ; ���7�°�� � Specify location in the building where work wiil take piace (e.g. floor, room , wing, etc ) � � 4340 BROADWAY � ! MI�CHANICAL ROOM � . - , - --- -- --- ----- - .� . _ _ � City ,, State Zip Code � ' Street _ - --_ -- -- - _ _ -__ �' I�l N�,�LR CU 80216 � ; 79l l'OTATO PATCH RD � _ __ - - --.. . -- -_ _ _ - --- --- __-_ _ _ _ a� ;_ , _ _ __ _ _ , _ _ ___ _ _ � - Telephone VJith Area Code i Colorado GAC Number � ; (.ity i State T County 7ip Cooe � � PrOo e t Su�pervisoOr � Co�o10 o Ce��Number � `; ��d�y cornaot � Et�pno�e � ;tnLCO � LAUI_� '. � 1 �,5 '7 , � _ ______ - -- -- = - �--- - Area Code ( Building Contact Person .� ' '' � � Ryan Myrick ; 11962 � 970-904-0108 I,EE DOROTHY (BLCT�) �andfill Name I Owner's Name � E _ DI N«K ARAPAFIOE DISPOSAL SITE �r � I HATHAWAY, TOHN & VERA _ - --- - - _----- --- _ _ _-- - -- � o ;- --- __ -- --- -_ _-- — -- -- � � Street � w� � Street °- � 3500 S GUN CLUB Rll _ � � � 400 iV�AN5PIELD AVE -- � i-- - _ - . -- - - Q I City State i Zip Code � � I City State � Zip Code ______ _ ____ _ _ u�', AURORA CO _ � 80013 ?� � ' DARIEN CT � 06820 ._ --- -- - -- — - �. — -- --- -- � p , Telephone With Area Code � Telephone With Area Code � 720-876-2620 � 970-476-7124 Colorado Project Manager's Name � Start Daie End Date � i 4/09/0'7 4/12/07 �- ---- -- _ .. - --- - ---____ --- - -- --- -- - . - - - ------ � Telephone With Area Code rColo. Proj. Dsgr. Cert. Number � Start Time �� End Time � � .� � 7 Qf} 3 : 30 � (� �� __ -------- --- --- -- �' -- � - - - -- � -- ---- � Colorado Project Designer's Name � Amount of Asbestos — _ - --- -- -- -- - � � — � i Linear Feet Square Feet: 55 gal Drums: � � Telephone With Area Code --�olo. Proj. Dsgr. Cert. Number � I �7�� 4� ��L� � � � i- _ --- ---� _---- _�_ __ � 1 4J ,' Da s of Operation - Check aii that a �I� � _---- ' - - — ---- --- - - I � - T ' � rAir Monitoring SpecialisYs Name � �i Sun ? Mon Tue. Wed . i 7hu. , Fri �, Sal , ; i .� � Joiaz� I�eterrr►an � / A � �3 Asbestos 'Tes�ia��Ca�sultp� --- - I_ _ � � � � � � : � --- --- - - -- -- � Telephone With Area Code Colo. AMS . Cert. Number � i i �' I 9�0-270-36�9 —� Emergency Project? � � � ' �.� - pr. � �� � ,� �, . � � � _.� : � � � . ,��. .� ; .�o-�. . �.�,: n � � � F � .� � �K �.��. � .��,<�,_ , , rw�; THIS �OX 15 FOR C [3PEi � 115E OfVLY: Project P�ianager Required? Y IV W r Permit #: Postmark or Hand Delivery Date: ;;. Check #: Issued : � __.. ._, �� .� �a� �.��, �. t .� . ��� � � � - �. e � _ � . � ��, . _ . . :P�K.,, ��,�,._. � �� � � � � ; �.�� � .. , � �� C'lease describe below the work practices and procedures to be employed in conducting the abatemen4 of asbestos . �� �9���1 �@� . Indicate type(s) of ACBNI to be abated (e.g . VAT, ceiling tile, TSI , etc. ). Use another page if necessary. � � ���i � � ��€ 6E ��s��a � nr��r�t sy�te� wEth �r�gi ��� rir�g �ontr�i� �� i�c����� ��� rn��h�nical ro�� �rarr� �h� �°��� e�� �h� �o€��� � nc! tE��r� �°�m�v� th� sh��� fl �orir�� �hi �� w�� with �� �a� ��r���r� �nly. °�h�r� �s c�r� l� ���c� �'�r � �h �°�� s�a�� � hc���r unit irt �he haii�ray� �u�� id� tF�e ��ch �r€ � �� � �°�€�r� 9 ��� �v� n this wi � i �� v�ry �Q � htp � cs � ��t� �czc,� r p��rr�tti�� i � r� 9 �� will use thi� �� ti�� �a��e I��d���f �� �� E � . �'�� � r��Er� area sh�Bl th�rs �� c(�� r��� ir� �a�•�par�fi�c�r� fc�r f� rta �s. 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' ' i ' � ` .i „ :. r � . ,.�� 1 { { t�\kOk. ';�i I� Ij �1��1 .�I�p�� ft { {� \tt �!i � �{�Q�6 t i. ��.i� � * fl ! �. . �� � 11 1 � t�. ' �! i 'f t ., .rl�� I 4 1 \ r • iit � � . .�� . . . .� �� l41� ke:' !�s�tf4{�t`��at• � !��a�� ��a��C<b�:' �°alt� lk6 �`�. ♦��6« 4 �j� ' is�� «�4�` i��� ..�' . ��«��p �{f`ie�4r ..,.. �I�{�{ f�{�t��: ' _ i �i ����t�� . �. tt < // e ( 46 �� .♦ f tr� ' O 4FOtr • F 141 � ' a4 6t0 . • .r f t � f 0 � L V� ♦ . ��� . � < . / " �� : . E�{�6te � <6s< � Q4. a 4 • .a 6 • �� ,iset�! i �6 { { { f ♦ s ! { ft � ' afd � { f� �t � . - . . . _� S .� � . a �4 a n. i�� .a ��� .. / . � a �a a. i . <:���! / � < �ia o. I � a �� a. ' � '1 � '. ° -/� i . = 4 TOWN OF VAIL Permit Checklist Town of Vail Fire Department 42 W. Meadow Dr. Vail, CO 81657 Telephone: 970-479-2250 FAX: 970-479-2176 Town of Vail Fire Departinent Requirements for Asbestos Abateinent within the 1'own of Vail The following items are required f�r vvork to be done within the Town of�ail. . ��i A Town of Vail permit is required per�rdinance No. 19, Series 19g8 A copy of the General Abatement Certificate, and State of Colorado certification. ' Information detailing the name of the on site project manager, with contact numbers. ti'� Estimated starting date and time a��d estimated duration of projeci:. �';�C N i'� A copy of written anangements with the facility operators for any temporary disabling of the air handling systems, fire sprinkler systems, and alarm systems with the names and contact phone numbers of these individuals. �'"� Site plan with details addressing: �� Waste container storage location • Waste load out area location ✓ Entry and Exiting details of abatement area ;� r�r j,a� Details of entry and exiting plans for the occupants of the structure in unaffected areas. :�- F1ous� I�� ���r lY a�;� i�� �� �i-(� �> �e�t=(? ►=�� t->�r�i�; �.�, �.tL;,�,l a5 SUG�►J A�S W� �(z� T>vrJ� �1iTl�l uu(� wol�K, 4J� W t�-t- Gt S E 1� 5�L`L� !-(�[�tl ��W` ��1�l l Crl 1.5 O!J �-Y A F�1�{' � ("l�N j tl 5 Uyi> �Ni� i-1��� ��,c5'i �EEl.s 5c�`zvicei� � AMERICAN ABATEMENT, INC. ENVIRONMENTAL CONTRACTING Specializing in Asbestos,Lead Based Paint&Mold Remediation � -��I`li!' . � . f�. � � 4340 Broadway 303.298.8550 �;� Denver,CO 80216-3503 303.298.8595 Fax •' www.americanabatement.com