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HomeMy WebLinkAboutPRJ06-0046 ASB06-0016 APPLICATIOf�! 4FUYLL. NOT B�ACCEPTED IF IN�tJ�1RLETE OR UN5 � / . a Q � �rt�ject#: �� "t� �� � � �uilding P'ermit #: - - � Asbestos Permit#: �' '' � u 71�WNt�F PALL � TdW� �� Y���- AS�ES�'(�� �4�AT��E�VT pERMIT APPLICATIOIV Requir�d �er Ordin�nce i�o. �.�, �eries of 1998 75 S. Frontage Rd. Perrrnit�pplica�ion �rli r�ot be a���p��� �A�h�ut the ffoilowing: Vail, Colorddo 81657 1. Copies of Generai Ab�t��r�ent Ce�;��aja� a�d ��.:ate of Colorado Certification 2. A copy of writl�n arrangemerfs wit� the s�a�i(i�,��peratars for any temporary disa6ling of the air handling systems, fire sprinkier syst�n�, �;�ci alarm systems with the names and contact phane numb�rs c�f�hese indiv;duafs. 3. Site plan with detaiis addressing: v�r�st� cQ�sa;ner storage location. waste load out area focation, entry and exiting details of abatefr�er�t are�. details of entry and exiting plans for the occupants af the structure in unaffected �reas. C�IV'i'l�AC"�"�Ft I�����F�7°��� On Site Abatement Contractor: TGw� af Vai! Reg. CVo.; �I. �'�r�r��and Phone #'s: ' (a r�-��.s.� C:/v�, S 6'�C i.rt--6.�Y-r`� �C)� ' �3 f) �``� 1 J� !`�G �,,i s.-LsJ t� �i�U ...�`Yv--Y�Y�'.. E-Mail Address: , �;�, ����} �����i �.�� ` ���'�° Contractor Signature; }�,� �� � COMPLETE VALUATIO(V FOFt AS�ESTOS ABAT�I+�E�i�° l�ERi�4TT (Labor& Materials) Asbestos Abatement: $ /�, �,,�. ,��, Contact Ea /e Covn Assessors�ffice at 97Q-�2B-864�ar�i��� www,ea le-coun ,com for Par�ce/# Parcel;a� �2 I a �-0 Z� � !`f-o i`� Job Name: � , � ;//'� /� cc� 4'�� �- 1 �2-`(� C��=�_.�����. �,�,�-�.f�. �t d� ,ab A��r�ss:, / . / � j��.�'7 �o C c.._-.G G{-�. �(.-'�k e � t Legal Description Lot: -� '" � lock:'��`�Y-� Fi lll���" I � ' aLt�CIjVlSIQII: Owners Name:�,�7��`�„v� G'��� _Addre��ss: � �t, h( �� ;4`✓zR;�`�t;� Phone: '�+�i '�+�� s -.Y-2� -- !;",1�, Z Project Manager: �..��� Address: Phone: Project Designer: Address: f'�w��: ���i�;�..���: � �. Phone: _ S.;�:,�,�� � � ��'� - `r'.S"�S "'��6 y` Air Monitoring Specialist: -Jd °�" Address: �� Pr�hone: � ��-v�a �_ Detailed description of work: � 0�1,����-�'�1�G � A'�L F"f.. Cr�� :��-L�•..... Start Qate: ��,t , p, End Date: r , �i /d� Start 7ime: � �,-r� Quit T�me: � �,._�� ��i� Amount of Asbestos: Linear Feet: Square Feet: _��_u�_� 55/Ga! Drums: Work Class: New ( ) Addition ( ) Remodel (.�) Repair (^) ��em� ( ) Other ( ) Work Type: Interior(j�) Exterior ( � 8oth O �� T e of Bld .: Sin le-famil Two-famil N1ulti-fami!� Corn�-nerci�l ' Re�taurant Other �- '� " � Does a Fire Alarm Exist: Yes O N� (� ,e M �st�m xi5t� ,.. v� � �!'� ,n c� . .� t � °.. . . .���*X��:�:�3:�:��:�:Ft)� ��F�CE ll�E ��l��'� �'��'�> ..er;�r�:a��:�:e�,:1:n�xxT� x � �:����;�*�r� ���*��*��**,�������:�:�*�*�� � � ����Oth�r �e�s� ,: � �s : �.: ua���Receive�t. .,� ,> .---�=--�--=�. �,,:���i �UG 0 4 �006 -;.. 'Public Way Permit Fee� ��` A�ce�#ed�o . � �;, �� _Occupar�cy Gr�o�up� �� , -� ., �� _w.�, r �° �.��1�u�&�T,��.t,� �1��� C�F VA I i� _ �--�- F:\cdev\FORMS\PERMTTS\Fire\asbestos_perrn_12-5-05.DOC /,�� `"" I Page :��;i i 7mSi�nnc °� �° �° Submit form to: ���0��lp�� 6 � 6 9 IFI � � I PermitCoordinator !F� � y� ,+ � � � � � I � � � � � � � � � � � Colorado Dept. of Public Health � "' � � �• APCD SS181 ment � � � � ;� *� FEE MUST ACCOMPAIVY THIS FORM . asoocherry �reekori�esoUtn �-� '��—���='% �j INCOMPLE-fE A{� PLICATIONS WILL BE REl� URNED . �en�e�, CO 80246-1530 V'� 1g � 6;i' Phone: 303-692-3100 _.. .. _ ( Permit will be mailed fo abatement contracfor unless specified otherwise) Fax: 303-782-0278 Permit T'ype 30�Day 90-�ay One�Year Notice Only "fransfer Courtesy Notice Single-Family Residential Dwelling ONLY �O Fee > 50 LF or 32 SF or a 55-gal. drum, but $ 165 $275 �385 �55 $40 <_ 260 LF or 160 SF or a 55-gal. drum „_ ,, , Okay to Fax Public & Commercial, School, and Single- ,;" � Family Residential Dwelling Building $27 � �550 �825 �55 �40 �� �e� >260 LF or 160 SF or a 55-gal. drum � Okay to Fax � Company f�ame Building Name , � ��-- ��" a � � -�,��' �°..�/� i,1„ ..) �'`f�- �- -( �b-!1��,,Y. ..� ``,Od `t � �.,e;t 1(�-�:�L; �-��' � .°. � �"•e � � ,z`� E: ,� _ , .., � - � Street � Specify location in the building where work will take place (e,g. floor, room, wing, elc.) e„ , _ .� ) % ��t�� _ . . .,-� E0� � r . . : I� �� �� ci.a � � !" .� � � �-` c'� ; c° (J .� lld �. F !<;� F�' :,, v �'-`�. �a� � City , S4ate Zip Code � SYreet t � / (/„ (�1` d ry // �// / � {�/ � J.% j _ ` � `. �,3 (.,..� � � �✓.� d � � G^ ���� `ln L± C �-"-..a.G.�' Q....,�i \ . 6. g:-G , �`�.r f�. Y ..} � �/ E�c P � � Tele�phone With Area C de Colorado GAC Number � City State County Zip Code °��' ! % `� `'� �' _� � �' '' �� 2. — % � .s' r�8 �' � m�° � �yir�- /;r_ CO �' c� l� � '�� S' f� $ Project Supervisor Colorado Cert. Number euilding Contact Telephone with Area Code guilding Contact Person � �.� F` .� C �� t�n; � r�> �-f�I r �, �v .., �a�. :��2� ', � ��=1�r� i�,�c:"� ���-r����,� t Landfill Name , Owner's Name � �� n . ie %" � °w /�% •. r,l. `�i. l'i'� � � �- G:�_ i� tr��:� t t�./�-� � �°- � �t's �.,� = Street 4 � � Street � %`� `� �v ��' � � i._F f' " O y �- `� � G �� �l �4� , %�- �.I'w` �` �;; � �._ ���. o Cityf� � State Zip Code � C City ,/ J � / State Zip Code (/� "^`.�Ui.Mva..�.�2�'.'.r�.. f.�_a��i....' 4...�-L-^' ;�✓ t`.Jc�.`e? �. � � V 4.,-����E/f.�'C" �. �} !`J�( i,�� ( � Telephone With Area Code m p Telephone With Area Code �_a� � �r -- `�� T l °�- .� I i ,� ,:� �: `; —� ? � � 7.�.� � Colorado Project Manager's Name Start Date End Date � ty y1""".°°"s � f�/ , . L' � `" '1 '°-£ . 4'� <F-' � Telephone With Area Code Colo. Proj. Dsgr. Cert. Number � Start Tim�, �} i L��� AM End Tirt� AM � a ' PM �. , <.�r:� PM � Colorado Project Designer's Name � Amount of Asbestos i � o Linear Feet: Square Feet: ` 55 gal Drums: � � w ! ``° ` �."ta � � Telephone With Area Code Colo. Proj. Dsgc Cert. Number � ,�,,j�\-7 �1 y� a,, — B�:.G..� .�� Cdwf\l. .t � � „ ' ii � � Da s of O era4ion — Check all 4hat a I : �, Air Monitoring SpecialisYs Name O '� +�- � .�- , d�_ � s� un. f�kor�. �l"ile. i V`u�eP• � ��rta� FEi��j �, �#. da •..�.J (,.J f.�v �1.i ��g'is%c.., �Pa �� �° >_. �''` a.. __.� ,� v o Telephone With Area Code Colo. AMS. Cert. Number � �r � . _ __ � E . � � .� �` � �` �f `° �°° `�� �y'� � � ' 2 Emer enc Pro ect? Yes o �.. . , . . .. . . �' , � �. . � �' . .._ g..... .. Y . i _... -.. � . .. . .. . , � � i i/ ._,- � • y . + ��• > . .. . , . , o �� n .- ._`. ' THIS BOX IS FOR CDPHE USE �NLY: Project Manager Required? Y N W ' Permit #: Postmark or Hand Delivery Date : � Check #: Issued : _ . _ o -� � .� � � , -°, o . , ; ,. w r� �� � ,r � � �P � _., .. , . . .. �; . Please describe below the work practices and procedures to be employed in conducting the abatement of asbestos. �E SP�CIFIC. Indicate type(s) of ACBM fio be abated (e. g . VAT, ceiling tile , TSI , etc. ). Use another page if necessary. e s �/ ry �_ /'�i pp f ��" �. ' , , `� ,� � �; � ( �J f "2 �- _���. `�-�- �-��w-� (..�-�_� i�� .�'� t�G��, ��,(, `� �y � l.h� (-J C���r�'f°`—" �l�ti,...�' �j'(-✓"^r...�.2+. :��'�ala'�., � �.,� �- �� µ:,W d �j � r:, ry��" �} ,_ .. �+, n 1� �y�°9° � '� f..` (;� , ...� t / � '�-��( �:G—��".' � �,_.�') � � �d.,.�� ,��� �,q ,, �-- � Z./V��.�+w$��b -n... Y "�"I_--�, f°"4'.n.,,.�s"Ld . � `� ij � Rev.3/03, J:Wsbestos and Lead UnilsWsbestos FormsWSBESTOS ABATEMENT NOTIFICATION.doc ��__ y � Caaacel ��� MiBI Levy `� � Owr�er i�arnefAdc# r�ss 46 .34100Q � i �,��C �_� Accouaa4 �Ii00r/ER, Cd41'FBEF2I� E �. � �1 : Leg�l Description R011045 � — _� . . _ _ � . �. . � . ._. ._---.__ _ �_ __.__ _ _ _ _.._ . _. _ _ __�__ .� . ', —�—��, 25119 EJS HiGF�W,41° 4Q SUB: BfGHORN TERRACE DESC: UPd !'3 19 BK-�214 PG-0474 Year District �, GOL�3Et� C� 80401 MAP 10-13-62 BK-02'i2 PG-0777 NIlD 0�-25-68 BF�-0494 PG-0866 � 2006 SC103 I DEC 11 -04-88 BK-0594 PG-0682 YVD '81 -'62-92 B@<-0603 PG-Q311 I, �D 11 -12-92 BK-0&68 PG-0266 CaCD 03-23-95 BkC-fB686 PG-0531 Apr Dis� St �, ; �CD 01 -12-96 BK-0686 PG-0532 C�CD 01 -12-36 V A Parcel Mumbes P�SEi Sp��e Seq 2101 -122-14-019 Street fVo Dir Street tVame l'ype Nm# II 0042�� s eo�unn � e � � � � ' Location City � Loca�ioea Z€p Acct "Cype �ag� VAIL Af2EA 0 BACode Owner ld �wner Locatioea �ap �o Business Naene �ersio�t V. C3ate Time ED Appl (Vew Versian 200604'i3000 13-APR-2006 09:30AM MJK ECAM ZU0608D2(3d0 � � � -- TYf' E �_ ACTUAL---� _ ASSQ ` ACRES �I — SQ F� i_ _ .�� �� tdame >:� Tax Items Protes� � � < <., CA�A ��) ---- � -- — ' �i Situs I FrelSuc � �obile Auth � PerrraBY ��� ID���"IAL� 299,480 � 23 830 0.�49 , — - -- , �� �, [� l�iobile � -�' Remarks � 1/alue I � Perso€�a4 (� �� � � � � Iracf � � Tax Sale � I� State d4sd I� �e � ar�d Gas � � I � � � � �—I Condo ' I S c Asmt _: i I � p � � Confiro! � Recc�rding � _ __ __ _ ___ __--- - ---- _ __— — _----- ---- ' �� �lock � � � Mines � �� � : �� ima asa � �T��,4L�_ 299, 480 23,830 f}.041 � [� tdistory � 9� J _ .._.__ __.__ _. _ '� �i_ �Sales �= ❑ Sibfin9 ��� ❑ PPCe�tL�r � �i E'ho�o QuerEes � _ - r--- - ----- — ------ , , � Misc (fd � FIa9� , ExemptBoi �I Sketch STR€�ET _ ___._ _ _ __ __ .__� ____ �� _�, Current Year Prior Versiora l'ax �'rx �� Nlail Trk ❑ Tax Chg � Nt�c� l'raek _ � Aect Ghe� Prior Year Ne(x)t olersion Abatera�ent i/alue Suex� Next Year Gharae�eristics Propee�ty Card ' i ' Upda�e CSear Exat I � ti� ✓ � °`q1,; � � — _ � � � t � � � � � �` �� � � � �� i l l� °�-,� c �_ , � � - � a " - - V�� �, �S � C � l�. �s � �` � I ` `� r w � SY�,��"`�� �. � �,� :� _ �. � L ►� �►�' � �� � � .� ��b�� ��' l . �� z° w _ � (,�- � V W F�' !TG(�� �-t� � .��� �. �' � � � K . � ') � o . �-� . 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