HomeMy WebLinkAbout932 W DRAKE RD - SPECIAL INSPECTIONS - 6/7/2017Planning, Development & Transportation Services
City of
Community De%elopment & Neighborhood Services
281 Nonh College Avenue
Fort Collins
PU Box590
fort Collinsnti CO 80522 0580
970 416 2740
970 224 6134- fax
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Asbestos Statement Disclosure
W .
Address
Permit #
In accordance with the State of Colorado Senate Bill 13-152, property owners, applying for a
remodel permit, shall indicate their awareness about their property having been inspected for
Asbestos Containing Materials (ACMs)
Property owner, please check the appropriate box below and sign
011do 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
4 O tt-. iz r- -
Date
Your remodel project may be subject to State and Federal Regulations requiring an inspection
for ACMs Asbestos can be found in these and many other building materials ceiling tiles and
textures, vinyl 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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