HomeMy WebLinkAbout211 Canyon Ave - Special Inspections/Field Verification - 03/30/2018For _ ^Rm
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Asbestos Statement Disclosure
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Address Permit 41
In accordance with the State of Colorado Senate Bill 13-152, property owners, app44)7 for a
remodel permit, shall indicate their awareness about their property having been inspected for
Asbestos Containing Materials (ACAfs).
Property owner, please check the appropriate box below and sigh:
® 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
❑ An asbestos inspection has not been conducted on this property.
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Signature Date
Your remodel project may be subject to State and Federal Regulations requiring an inspection
fc,r ACMs. A.shesto.s can be �ourrd in these curd many other building materials: ceiling tilts arrd
textures, vinYl floor coverings and mastic, boiler and pipe insulation, heating and cooling duct
insulation, roqfb�,a products and clapboard shingles, etc.
For more information about Asbestos, please contact
Asbestos Compliance Assistance Group
Phone: (303) 69_2-3100
}'TTP: t+.t-it.colorado.,,oi!ctitrheasbestos