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HomeMy WebLinkAboutASB07-0025APPLICATION WILL NOT BE ACCEPTED IF INCOMPLETE OR U I �•��� _ � Pro�ect #: °� � r -� "� � � Building Permit #: �� � ,-` ����j � / � �'�' �"' �� Asbestos Permit #: � ____- i� '_ _- __ T1DA'NnF�A�, TOWN OF VAIL ASBESTOS ABATEMENT PERMIT APPLICATION 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: �.i..,��ss��..i, �Y• ��c�.s 7�? S /'`'1/iCC �aW� tNLy �7�-.i��i Zl E-Mail Address: �,A.,,� �y �a� � Ce�.tu�r f e� •,�e,t Contractor Signature: /,�,� � n��� ' COMPLETE VALUATION FOR ASBESTOS ABATEMENT PERMIY (Labor & Materials) �.��, I� Asbestos Abatement: $ / �,o Contact Eag/e County Assessors O�ce at 970-328-8640 or visit www, ea4/e-countv com for Parce/ # Parcel # Job Name: }-i� 1•�l�q-%+�D �Vilpc:j'- (�10 [�Gw�+ ��L%� j'� �-� � �-c L Legal Description If Lot: �(J - 1�gck• �i�:� Owners Name: Project Manager: Project Designer: Air Monitoring Sp Detailed descri ��i11i:Ui_ Stait Date: ` � M ��� Addre�s, Job Address: ��d L� Q�s �.Ck.p C�/�C L L` �l�j �I Address: ' � Address: Address; -cx-. � ,�,���� ;u�� l� ��, � of work: �'� S�'= c`%r1l `��Xi -T- ��; 1 End Date: � I ' �L� i;� [: Amount of Asbestos: Linear Feet: Square Feet: _ Work Class: New () Addition () Remodel (�j' Re� ( Work Type: Interior ( �-} Exterior ( ) Both ( ) - �I Subdivision: �� � , Phone: � � Phone: � Phone: �-„�/. � Phone:- �,`� -`��J 3v I Drums: —���3 � yj t Type of Bldg.: Single-family O Two-family O Multi-family O Commercial ( "R stauran�'( j�Fi"�('""j""`"""""°-�` Does a Fire Alarm Exist: Yes (� No () Does a Fire Sprinkler System Exist: Yes (-�) No ( �**�������*������������*�**�:��������*��FOR OFFICE US� ONLY�*�:����*����x���x�,�����.�� �:�:��x �_ e.,., � - _ ��T_..��[��\!I[� ;, Other Fees: Date Received: '` D Public Wa Permit Fee: Acce ted B: �EP 13 20Q� Occu an Grou : ,; F:\cdev\FORMS\PERMITS\Fire\asbestos�erm_12-5-05.DOC Page 1 of 1 � -rn�NN (�F ���oos ���� � i Cancel STR Mitl Levy --- Owner Name/Address 49.625400 � __� AFIC Account R008988 N Year Di§trict 2007 5C202 Apr Dist St T A Parcel Number 2101-063-07-061 Street fdo Dir � LANDMARK COMMERGIAL DEV CO 610 W LIONSHEAD CIR STE 100 VAIL CO 81657 �treet Pdame �000610 IW �LIQ(VSHEAD LocaYion Gity � Location Zip VAII. AREA 0 BACod� Owner ld Owner L.ocation ,��F.1"�t� IMH Space Seq Type CIR AcctType Lag4 Map Rlo i�_j f?lame � Tax Ifems I� �'rofies(T) '� CAM(A) 1-YPE - r� 5itus ❑ Pre/�uc � 1 PVI(o)bile Autt�- >� P(e)rmit '�-��� __ I_ :i IMP� � ; Mobile , _ Remarks � _i, yal��e ❑ (�')ersonal IJ �'raci ir� iax (�_)ale L� �tate �sd U Oil ar�d �as ' �,I Condo �] 5pc Asmt �r� Controi � Recor(d)ing �,, : L ��lock � � tV1(i)nes ;� �iistory �; ��� Imaging W�T'AL y r� Sales �� Si(b)ling �; PPCer�(L)tr � P(h)oto _ _ _- ;�� IVlisc (Ni) I �� ��ags [ � Exemptioi � � Sketch � S'TRE�T _ [; Mail (F) �� Tax (C)h< < � Miq Trac(k) (V)alue 5um L CONDO: LANDMARK-VAIL CONDOMINIUMS DESC:COMMERCIAL UNIT BK-0237 PG-0393 BK-0275 PG-0908 BK-0332 PG-0657 10-16-81 R899228 EAS 11-30-04 R937612 EAS 11-21-05 R937613 EAS 11-21-05 R200601187 EAS 01-17-06 R200625045 DEC 09-13-06 V. Da�e ' Trme ID Appi aa-,auc-zoa� �1:�r �� cs aams � ACTUAL � ASSD IACRES +� - � : i it.f 1,017,420 1,886,260 251,960I 0 _..._..— 295,OS0; 547 0 i01 ----- SQ FT Current Year � Prior VersionQ � Tax Trx V n Prior (Y)ear Ne(x)t Version Abatement (�1)ext Year Characteristics Property Card Update � Clear � Exit �v�� i.�rvti"-� �t��-0 Low�s ; t�vL� EA-s, �'�ci'�ci s P�� , i i, ; � I i I � �i i i , � � i`� ��� i �� � ! � �" i L.C!� I I , '� i '��� I I� ;� , I I � ;�1 i � ��� ' o � �1�,' � � _ __ � � ' � � .� � .. I i I 1 � � � � , I � , I , � j (� 1'vl — �� t�—�?�.� I' ��� c;fk a'�1�c- � I � I _� � _ ti , �, ' i �'� �.�t �,: �2 i ¢' ,`��'� ; , y il'U � �� �-I I I � � � � � � , — i � " — _!"_b!ti.�1'— � �-1� �S:/i S �rw.� S ;� `" � � I j�— � ' ' 4 --_ � I � I_-�'_. _.. __..'-' p� �.�n i � -�"r�--F � Lr- r I �t�' �- ' _ . I-_I "__-� . __ _ ..-_- _ '- a �3�� �—I.� �� � — . � , s � I I.--, ���-�- --�- ��-'t� - — � , I � — , Q= � � --� " �I — , ' —� i ,--- � ' o �c� u,± I "I r�, � �1L:r�'_ � i �� QL �6���� _ '�' jv�� ly.� _ I �"�� � '�� � � ';� � � -� � ; i— -- — —� � — _ �� . I I_' , i � ��' l— s�s � _� �i � � � , � � I I � 1� lLl �l2. ry� � �L,' I �`r �� o c� I � I —L--___ , , � I i � p -- - - � I ��1�� �i ���� _�� � - � � � ; , - , �� � I ��� I� — �C' t'l�.A �Y t �Y' �t�/ tC� ��JGd 3:�d �i��f�f�L���d� L� =�t� �.C�C��, � � I ,i/ � �" � i r .�, � � '. �F �"` Dba 1'rofessional Environmental Services LL,C Vai1970�949�9911 Corp�rate ()ff�ce �44 Se�ond Str•eet, Eagle Coloi•ada P.O, �o� 5110, Eagle, Colorado � 1631 I'hon� (970) 32�-3730 F'ax (970) 328-3731 IvIike I�owlinga (970) 471�5921 Cell r� 'r_ tf Ts�wn c��f Va�l ��� " i= �'ii;,i' i's'�'v �. We vvill be izsrr�� n��;�tiv� ��z° �nachines l�b�l�cl 1�4. Th�s� Ynachines are a111ess tl�a� 3 years old and ar� servzc�cl zno�ihly wzth t11e last s�rvi�e P�.u�ust � 0, 200'7, j ' " Submit form to: ;.oF����o ASBESTOS ABATEMENT NOTIFICATION PermitCoordinator ��4' � �\ Colorado Dept. of Public Health %�,�..-� d`� and PERMIT APPLICATION FORM and Environment �'�* :��i FEE MUST ACCOMPANY THIS FORM. aPCO-ss-e� �. / 4300 Cherry Creek Drive South `*�r��=����` � INCOMPLETE APPLICATIONS WILL BE RETURNED. �en�e�,C080246-1530 �'� / g � 6, j Phone: 303-692-3100 �,....._ (Permit will be mailed to abatement contractor unless specified otherwise) Fax: 303-782-0278 Permit Type 30-Day 90-Day One-Year Notice Only Transfer Courtesy Notice Single-Family Residential Dwelling ONLY No Fee > 50 LF or 32 SF or a 55-gal. drum, but $165 $275 $385 $55 $40 Okay to Fax 5 260 LF or 160 SF or a 55-gal. drum Public & Commercial, School, and Single- Family Residential Dwelling Building $275 $550 $825 $55 $40 No Fee >260 LF or 160 SF or a 55-gal. drum Okay to Fax L Company Name , Building Name i ° N��;� ���� S�,-��c�=J G �o ��ows�L� e�R�L.L ` Street [� � Specify localion in the building where work will take place (e.g. floor, room, wing, etc.) o i2�i3 7�=.�-r-i ya .Yr��_�c-- � Lou�szLruC�- Rtra� S�a�c; Sc-:c� V City State Zip Code C Street � r��,�..t,� c-�, `�� �� U � y� � G �v L.roa�s ��o cc•2c c,c: � Telephone With Area Code Colorado GAC Number +�+ City State County Zip Code R ' � V l� � ,L � !e lfLG�' � �'7o_Lttl-���i2' � I�CS'7o� J a co � Project Supervisor Colorado Cert. Number Building Contact Telephone wi�ea Code Building Contact Person a .a�9�> � i�1,�-�,°z-i�,`u� �% c;� � i� %� - �9 z �L Y �'7 �-2�c- G��14�. �.4. Landfill Name Owner's Name a� �L 1ht�t �-1'�-w,0 i�l �L- �, � ✓Lt A� �- G� C! c�. � e�� ` l ��.�, � Street 3 � Street �e � Q`f �/ C-i� A- W T°G2. � 0 Y Qb k�+ 4� Sr � City State Zip Code = C City State Zip Code �- � � C � �� � �7 7 � ° (/ t � �, ' f ��,d.., (�-��" �--t � �: _ c.� �- Go Ld � r e s- 7 O Telephone With Area Code m`p Telephone With Area Code ' `�� -�7.) -t'��3' �" c�a-C_'Z!g- 4r4�j' 'G'iZ`f� Colorado Project Manager's Name Start Date End Date � S t���o� D-�- �7 0 � � � Telephone Wth Area Code Colo. Proj. Dsgr. Cert. Number Start Time �`�,.�� qM End Time AM C� _ . ° PM G - v-� PM � �' � Colorado Project Designer's Name d � � a Telephone With Area Code Colo. Proj. Dsgr. Cert. Number � �o � Air Monitoring SpecialisYs Name a�i f L^ L� i`v ' i�� /-�'t. ,� � Telephone With Area Code Colo. AMS. Cert. Number 0. "30 : j .__ y - ,�»� y .Z� `� Z_ THis Box is FoR CDPHE Use ON�v: Permit #: Check #: R � p Linear Fee = � d .� � un�a 6 bo Po �oeration — Che � Emergency Project? � Yes � Project Manager Required? Y N W Postmark or Hand Delivery Date: Issued: Please describe below the work practices and procedures to be employed in conducting the abatement of asbestos. BE SPECIFIC. Indicate type(s) of ACBM to be abated (e.g. VAT, ceiling tile, TSI, etc.). Use another page if necessary. l c,�� �,�i ' � c�� � v r K`�'�k`�.�.e� ' �!o w I� � �� l h. GL�•.�t.. i� S�•�.e.�,` � �`�.."`' w``.� y��..,�i/�-d �—� u.,(�, c�cr,.`�'� w,. � �..�7it. G�a� . �i, �'r � G��� �"''`� �e'"� ``.�s � �,��,�,�. P aU!�;,,�,�;,,� c�,,�,� �,�.,,,,� � �,�a �l � s �, � s � , /� s � w,,�,t�, �,�,,,-t�, (.�,.�t � �r ��� p� e G6 k t.� r� �.,-i,(,Q (�2.. �`-c 1!a �P_a( . Rev.3/03, J:�Asbestos and Lead Units�P,sbestos Forms�ASBESTOS ABATEMENT NOTIFICATION.doc �