HomeMy WebLinkAbout120 W Olive St - Special Inspections/Field Verification - 01/08/2018Planning;, (Development & Transportation Services
City of
Community Development& Neighborhood Services
College Avenue
Fort
Collins
P.Box 580
P.O.Box
Port Collins, CO 80522.0580
970.416.2740
970.224.6134-fax
fcgov.com
Asbestos Statement Disclosure
12-o W. Olive+e 220
Address
Permit 9
i
In accordance with the State of Colorado Senate Bill 13-152, propertyowners, applying for a
remodel permit, shall indicate their awareness about their property having been inspected for
Asbestos Conlaining Malerials (ACMs).
Property owner, please check the appropriate box below and sign:
❑ I do not know if an asbestos inspection has been conducted on this property.
An asbestos inspection has been conducted on this property on or about
9/201(, .
❑ An asbestos inspection has not been conducted on this property.
Signs it Date
Your remodel project may be subject to State cud Fedcrul Re,gnelations requiring an inspection
ftu' ACAlls. Asbestos can be found in these and many other builcling materials: ceiling tiles and
textures, vh);I floor coverings and mastic, boiler and pipe insulation, heating and cooling duct
insulation, roofing products and clapboard shingles, etc.
For more information about Asbestos, please contact
Asbestos Compliance Assistance Group
Phone: (303) 692-3100
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