HomeMy WebLinkAbout640 PETERSON ST - SPECIAL INSPECTIONS - 7/17/2018Planning, Development S Transportation Services
City of Community Development.- Neighborhood Services
Flirt Coth MUt s P.O.O N College Avenue
i6 '�PBox
580
Port Collins, CO 80522.0580
970.416.2740
970.224.6134- fax
fcgor. com
Asbestos Statement Disclosure
& Y (/ P-e V-� f 190571ai
Address Permit # r
In accordance with the State of Colorado Senate Bill 13-152, property owners, applying for a
remodel permit, shall indicate their aivareness about their property having been inspected for
Asbestos Containing Materials (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
..ld'An asbestos inspection has not been conducted on this property.
Signature Date
Your remodel project may be subject to State and Federal Regulations requiring an inspection
for ACMs. Asbestos can be found in these and marry other building materials: ceiling tiles and
textures, vinyl floor coverings and mastic, boiler and pipe insulation, Treating and cooling duct
insulation, roofing products and clapboard shingles, etc.
For nrore information about Asbestos, please contact
Asbestos Compliance Assistance Group
Phone: (303) 692-3100
HTTPalwww. colorado. eov/cdphe/asbestos