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. <br /> . <br /> Minnesota Pollution Control Agency . <br /> Notification of Intent to Perform a Demolition <br /> �� Type of Plotification [ ] Original ( ) Amended [ ) Project Cancellation <br /> Demolition Contractor• Building Information• <br /> Name: �%c;%� c.���i�ir.� C�C.4-.i����.../ /!� <br /> Building Name:_ �/ <br /> r <br /> Address:__ �`7s'c w /C���i,`�� .Sj7�c�7' Address/Location: �7,1G /_Si'�oc.��1 �v�aa� S <br /> City,State,Zip: �/�v�✓�' t-Lr_,J S J�.3/ <br /> City,State,Zip:/SC_�%��ir�G �-�✓�. �� N S-j—y r; County: /�iV�t�c�'r.:' _ <br /> Contact Person: � �/''�"��� i-���1�»� l�/,A- <br /> Phone Number(s):__ <br /> Phone Number(s): ��.5� ' `1�i,�i - L `�'��� Age of Bldg.(years): D� Size of Bldg.(sq. ft.): <br /> Number of Floors Including Basement Level(s): � <br /> Building Owner' Present Use of Bldg.: �Z����Jt .y�ri.'}�. <br /> Name: �%�,✓G��%v���� i��c�•��-i �S�.�ii,Y) GL<. <br /> / Prior Use of Bldg.: >�.��F� <br /> Address:_�'/KLc> S�N�2c;� /�✓�` l�/i.. <br /> Dates when demolition or intentional burn�ng <br /> , will Begin /`�%��- / & End N/''�/. � <br /> S pr N� �','�'�.iL �;� �, ., <br /> City, State,Zip: ' � < S � -� <br /> Notification must be postmarked or received ten(10)working days <br /> Contact person: SU�� t'r �T�S �"J before demoli[ion begins. 'See item#5 for emergency demolitions. <br /> Phone Number(s): �� 2 " `9�� " �'� c`/ Boch Beginning and Ending dates should be amended in writing as <br /> necessary to reflect current project dates. <br /> If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC1Vn in the building <br /> to be demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of IVI�i 1- <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removat. <br /> Is nonfriable ACM present in the structure to be demolished ? [ ] YES [�NO <br /> If YES complete items 1-9. If lr'O complete items 3-9. ��� <br /> 1. If ACM will be left in place for the demolitio❑ indicate the amount of Category I and/or Category II <br /> nonfriable ACM left in place. <br /> Categ, I Linear Feet Categ. II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> Categorv I nonfriable A�'M means asbestos-containing packings, C'.ategorv IT nonfriable A l��means any ma[erial,excluding <br /> gaskets,resilient floor covering,and asphalt roofing products Category I nonfriable ACM,containing more than one percent <br /> containing more than one percent asbestos. �sbestos thac,when dry,cannot be crumbled,pulverized,or <br /> '`Category I nonfriable ACM is not allowed to remain in place reduced to a powder by hand pressure. <br /> for demolition if it is in poor condition. °Category II nonfriable AC�1 is not allowed to remain in place <br /> for demolition if it has a high probability of becoming crumbled, <br /> pulverized,or reduced to a powder during demolition,transport, <br /> or disposal. (ex transite,cement,slate roofing) <br /> 2, Deseription &r. �.acation c4'��i�� remaining in place (including fioor# and room #}: <br />