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PRJ04-0435 ASB07-0015.pdf
Ma� z4 07 12: 52p Doug Tarnowski 303 471 6479 p. z i APPLI 710N WILL NOT BE ACCEPTED IF 1NCOMPL�TE OR UNSI �6�.. ��S 1 Project#:__.� � .- S� � ` O�/� Building Permit#:— , ---7 �r `� Asbostos Permit#: , ,� _ -- =.��d��..� � � � 7�WNOFY� TO�N._OF VAIL..ASBESTOS ABATEMENT,PERMIT APPLICA710.N Required per Ordinance No. 19, Series of 1996 75 S. Frontage Rd. Permit appli�ation will not be accepted without the following: Vail, Colo�ddo 81657 1. Copies of Gonor�l Ab:�tement Certificato and State oi Colorado Cort�fic3tion 2.A copy of written arrangements with tho facility operators far any tomporary disabling of the ��ir handlinq systoms,fire sprinkler system, and alarm systems with tho names and contact phone � numbors of thoso �ndividuals. /�� 3.Sito plan with details addressin�: waste cont:�iner storage location. waste load out arca � 1� location_ entry and exiting details of abatement area.details of cntry and exiting plans fvr the occupants of thr�structura in unaffQCtvd�ro;ys. CON7RACTOR INFORMATION On Site Abatement Contractor: Town of Vail Rog. No-: Contact and Phone#'s: �'�1 � 7 1 �O� AS�N :�N�USt2l�5 L�C �,�y�S a �l�NQ�.�K/ ... .-- --.. .. . . —----- .__. ._ ..._..... .----�— E-Mail Addross: ,5 %UZ/l,�Q �2.0 k 5 � 'U r/✓�/�'I L � (.'L'/� Contractor Signatu�o: ,�,- � C.' COMPLETE VALUA710N FOR ASBESTOS A6A7EMENT PERMIT (Labor 8� Materials) ..... �,�, v•rrCF:� l�7s��Z5��a.�l �Asbostos Ab�tement:$,��J��/� N r---� Contact Ea le Coun Assessors dffice a[970-328-86d0 or visit www.Pa le-count ,com fo�Parcel# .., . Parcel# /U a�/ yQ/Q/'� , .... _. _. Job hl.�me: Job Address: ✓`�.�{�%f/Fti'�'�� �c CS i/J�N e� ..�73' /�/a oNr k G•�iv Legal Description Lot: //� Block: � Filing: � Subdivision: (���� ` •�C/+J� '� � --- �� -.. " _ ... ...-- Ownors N�m • ,,, Addross: Phono:�,, , � - c I � _ ��Y��r'�TfP1��JN�,-� �ax y�� v' , '�o �o �yl .._.. ... 303 .S�'T "-5'� 8 Proje Mar�ger; . Addres : . . Phono; rs - �n�K �z zr - S L.A� Y T Y 0 �% rIl .���i,�,szQ� . '— ----...... .•• •- .__.. . . ..__�.__..._..._.._.. Projdct pe pnor: , �e 2 ��. �ddres��: �� i r Phonc�: �� � � Air Monito ' g Special's• �.2Z= Address: 7 � � � Phonc: 1 � / �' ' ' , . . . . . . _. .,, . Detailcd description ol work' ��i/y1Q�r/�� v/'�- /f � �r�X � �»�r��� Y „��c}.54'�u�/�� ��=4�Z� �/� ,�.1RID �fG�M f�C 0 D/1J/✓6 G/.���/L ��L G �TD�t�':~A�.vrn frv>�ND��r�a N 5 —�l/!1%T/1� Q. Start Dato: �� "G� '•j End D:�te:-. �' � ('J l Start Timo: �`�%V.4/r►. I Duit Time: " .'�O Q�. Amount of Asbestos: Linear Feet: ^_ S uare Fect:�0�� � . . .. °... ....._..._...... ....._....._.. ___ q __ 55/Gal Drums•__.,,�— Work CI�:,,: Nc�w( ) Addiiion Remodol Ropair( ) Dc�rrto Otho�( ) Work Type: Interior(� Exterior( ) Both ( ) T �of Bld .: Sin le-fr�mil 7wo-4�m�c Multi-f�mil CommcrciAl Rcstaurt,nt Othor Does a Firc Alarm Exist: Yes( ) No Does a Fire Sprinkler System Exist: Yes( ) No :�:��� �+**** * w,vw�,�wwww wwwrweKS R ww w wor xxx+x�Y+**+.h***wwwww I Other -- - --- - -- ceived: ' ������ � Publlc Way Permlt Feo: � d By' ! � Q �Occupanc u : � � �. 11Vai RMS\PERMIT5VISBEPERM.DOC � __/C/,P('� ,r�4�r rnP �� - S���F D/ ���� _ ._..�_. iX �� ,/ C�f����'✓Z L tJ i t� / �/l! �. � / _ --��6�'�K l� �'�G�4� 5 __ _iv � - � – ,� `���� - �����n� �GC�� K ��C l-(�n: � � t� 1P �, �� � " _ _ ��'`�� �' �� � _�GU� ���11�-1.L �j/����� _ -ro �(G�� ` \ /�-ni< � � ��, ��r`iG`� � Y�`�� -� - � . � �! , �� /������ , �z � , ��� /f— �/.,1l�1 C' C. ���'1 ~ � 1 N N i � ,.. 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Cd o� � ;� ._ �$ . . _ • -. _ __ e�. , _ �, _ . . _ . - - � � - - - . . _ . �� a��, a� � . � � C{ � !�. 1 � 1 � 4� O V 1� � .LJ 6A 4d � � �I 1 I I � � � � V S 0.y � 4J � � i � � � WJ � Y + 10066 � . ��c:�tCard �I�cc° , �iighl�nd5 �1nCh , �� . $0125 " • ° • �han � (303) 791 �5d17 °Y'am "t°o � �� V�el �uildi�a� �� �4 ��t „� , F'� m Douq `��rrrovN�ki ,N, ,� ���: s7a ��9 ��s� ��� o � �� : ���r�i ��ow7 x�o nrlay �� , 20�7 ��s ASbc;stos Ab�yt�;mer�r. P,ppiic..�tion �� o FZo�rt �teph��o4ff ❑ ll ��nt ��r R�ve� � �8���� Corn ot�t � �1e��� ��piy � �1 �e ��� t� � ��rr�m�nts: � Att�ched is a copy �t our As�e°stos Abatervtent �,pplication and as�cia�ed doeuments. 7he ariginal documc:nts will � dcliver�ti by U� Mail . This project h�s k�een �rmittEd undcr Notice Number 07SU2502A wikh th€�: Colorado Ocpartment of Public Fie;alth a�nd Environment (�DPH�) , tor �a start � da�tc of May 30, 2007 . Th� nk �ou for you assistan� in this rnatter. Please �]ircc� any questions or r�equests 9�or �dditie�nal in�os-rn�tie�r� t�: �oug �Tarrsovvski t Presidcnt A;; pt�;n Indu:at �'i (°� � �.L� 1006� � . Sti°atfOr'd PI,�C� , heighland� Ft� nch , �� . 6012C F'honc; (303) 79'1 -SO'17 �;ax (303) �71 -6479 �ft'I�il . a�nindus4ries,�hotmajl G�m Att� Chc�C3 doGume� nt� includc : � PCrmit r4�plic<°�tion � � ht;�Ck # 7396 fo �' � 11 �. 00 • Copy ot the COPH � issued Asbe�tos Ab�tement Permit � �apy of P.spert Industri�s l,t�C � �A� Licensc �nd 1'OV C�rtifie�ate � 5ito F'lan show�nc� abdli��mertt e'3r�,� , .� nd lot pl� n b � � ... � � STAT� OF COLOIZADO Bill Ritter,Jr.,Governor James B.Martin, Executive Director oF•colo ��,'_:_��.�-�P Dedicated to protecting and improving the health and environment of the people of Colorado ��%��90 4300 Cherry Creek Dr.S. Laboratory Services Division * ��� ; * Denver,Colorado 80246-1530 8100 Lowry Blvd. *��'�_`�' � Phone(303)692-2000 Denver,Colorado 80230-6928 *�8�6� TDD Line(303)091-7700 (303)692-3090 Colorado De acttnent Located in Glendale, Colorado ofPublicHealth http://www.cdphe.state.co.us and Environment June 11, 2007 To Whom It May Concern, On this Date, Col Construction, Inc. submitted an Demolition Permit Application for a residential sh•ucture located at 2339 Chamonix Lane, Vail, Colorado to the Air Pollution Control Division at the Colorado Department of Public Health & Environment. The application is approved with the work dates of June 13-22, 2007. The original permit shall be delivered via US Mail upon processing to: COL Construction P.O. Box 4573 Vail, CO. 81658 You may contact Curtis Burns at 303-692-3153 for any questions pertaining to this letter or demolition application. ��� � �i - __ ___--_.__.� Curtis Burns Indoor Environment Program Colorado Department of Health & Environment 303-692-3153 Curtis.Burns@state.co.us ��� �� 1� y�3 .�� � � � L� OMI� .1t�� �? � ��0� � , alt5` TOWN OF V�41L �o� • o�r5 Submit form to: /�� C�� °� Permit Coordinator �� �'� � � ��' � @ � ' �� � Colorado Dept. of Public Health l��c ;�;"' �- ' ' n1 A $55 FE � MlJ�7' r4CCOMPA�JY °T"HIS FC) RM . and Env�ronmenc APCD-SS-61 �� � ��`��� �� I �ICOMI� L �T� APPLIC�P��IONS WILL BE R��TU{�N � D . 4300 Cherry Creek Drive South � � " - ° � �� 'ermit will be mailed to demo(ition confracfior unle�s specified afihe:rvvi�e) phoner303�-692�100 O 18 .� g, � � Fax: 303-782-0278 � Company �ine � _�� �0� � 6uilding Name Year Constructed � �' — � t9 � � � Street � 7ype of Buflding (i.e. residential , vaarehouse , offce building, etc,) � P� �� � � S`� � � � ;. i �'c� �°'l G� � City / State Zip Code � Street V � �%' o ( C c� ��s� = c� :�.� ( `-° I�A/�� ! o�� U 9 m 'Pelephone Wdh Area Code � City State County Zip Code � q,�° � 3 �- � °' �✓,�� 9 � �'�- i L. co �J � s � Project Mana er Cell Phone Number with Area Code Proposed Start J�te Proposed Cqmpletion Date l, � ,S�z� �� �,`�� 9 �� r 3 9a � �.s��. 9° J�.� �, �r��� � J�� ���� 2 � � � Landfill Name/ Owne 's Name �w / iC � u � � � / � �/ eo � / l C / / /"� � � � � � � �� �� � � Street � � Street is �. i. a^ � i � / t? � �v ��o jc° '°v'�-"`��� � � City State Zip Code � � City Stafie Zip Code ,� L�/'� 1c�� 7G G� � l G S ,S�°" � ° l�.� � � �3/ � � Telephone With Area Code � � Telephone With Area Code 9 0 - 9' G - 3 � � � 00 9 ,�d - 3 9 0 - �.s"'�. 9 Inspector's name "*`Note: Slgnature is required below"` Generai Abatement Contractor (GAC) � �� � c. e-�z�t� � .�. c. i-� �. J=�.,�' ;� 8 r � s 3 � 9 3 � � Address ^ � CDPHE Asbestos Permit Number BO lo � � � � �-�•/ � � � O � � � v �i �� � � fdt v City Sta�te Zip Code � � Total Quantiiy of Asbestos Removed � N �, �c /\ �L�.'l./LYJ, C f.' , " vr� � � O � G- �C� � � � � � Colo. Cert. Nurriber F�cpiration Da4e °''y O Da4e Removai Com eted � io 7 �7e g� � I � mc� � � " .�.,.� � � � � � � Date(s) of nspection 7elephone With Area Code � Telephone With Area Code `( t �7 � � - � ~v �c� a �- �6I �. 3 � 3 � � � m ,o l � `** With my signature below, I eertify that I possess current AHERA and state of Colorado certification as an Asbastos Building Inspec�or. 1 also certify that I i verify 4hat ali refrigerants hom aie conditioning/refrigeratian appliances have have inspected the bulldfng to be demolished, as tisted in the DemoBtion Site been property recovered in accordance wiEh AQCC Regulation No . 1 S (For � block above, sampled all sugpect materials (in accordance with ANERA), had � information on CFC requirements call 692�100). � ail samples analyzed for the presence of asbestos by a NVLAP accredited � � laboratory, and have determined tha4 (check appropria4e kox and sign irr � CH�C6C 7tiE APP�OF��I,Q°f� �OX: gg �LU� IIVK): � � � � � No ACftR exis4s anywhere in ihe buiMing. p �uilding Owner o � The only ACM left in the bullding is non-friable VAT and/or tardmpregnated � � � roofing felt and these will remain non•fiable during demolition. � �� � � � AII friable ACM, or ACM that may be rendered friabie during demolition, 4ha4 I � � � " ° inspectfon been corcy�lefeiy removed from this bu�ding, per my visual � Contractar /' / �° ,� � fJ O L � ( C� �7 S' �s°r✓c ( <°� rd '�°�- a. � Date of Flnal Inspection � Date 4� � � � �"° � .� � 7 `� ,e� �. � � l � d � ?� � Signature � '� Signature ����._--- ��-�� �ss�� � Printed Name Printed Name = C� I � c�lot�S fJ_4 .S� ������ . . .__ . _ ., ._._ .� . . .. _ . . � . . . . _ .� �°1G , v .���' _ _ � � _ : , . ��-� �� '�. _ _ . q , . .__. T�Fi1S BOX IS FOR CD�I°I� USE ONLY: ��� Permit #: Postmark or Hand Delivery Date: � ��%�'� �' Check #: � � ��� � � � ,.� �(a� �� Issued: �� �� Rev.3Po3, J:\ASbestos and Lead UnRs�P,sbestos FormsWSBESTOS ABATEMENT NOTIFICATION.cbc