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, � ' Minnesota Pollution Control Agency <br /> Notification of Intent to Perform a Demolition <br /> �� Type of Notification [ J Original [ ] Amended ( ] Project Cancellation <br /> Demolition Contractor• Building Information• <br /> Name: 6t SOn� Cv�:%S'1,2�iC7r�:' C.1 /�UC: BuildingName: �Sfp£d7rr�, <br /> Address: ��?Q i��Aj'OC)!� �OR�> Address/Location: �45 �YSr t�� �Z J <br /> City,State,Zip: 0%u�JC ; I��J <br /> City,State,Zip:�v�.00r'J� M� �'�'Z County: <br /> � <br /> Contact Penon: �f�+�+� 0 ZS'd� Phone Number(s): �S Z� ��1�- •?7 7� <br /> Phone Number(s): pi SZ-4�4�-�6 7� Age of Bldg.(years): a� Size of Bidg.(sq.ft.): =�5�� <br /> Number of Floors Including Basement Level(s): Z <br /> Building Owner: <br /> Present Use of Bldg.: �S���L^7✓�-� <br /> Name: ��i L .Slm� '��s����`�,� <br /> Prior Use of Bldg.: <br /> Address: 4lri`�S ��NS 10� 2 D <br /> Dates when demolition or intentional burning <br /> will Begin /�S-�P & End 3����+c�.��, :c`��S <br /> City,State,Zip: G2U�3 , �'1� <br /> �_ Notification must be postmarked or received ten(10)working days <br /> Contact person: 1 f2�y E iD before demolition begins. 'See item#5 for emergency demolitions. <br /> Phone Number(s): �SC- 4 '�!'Z'" Z 7'�L 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 (RACi1� in the building <br /> to be demolished,it must be removed by a licensed asbestos contractor prior to demolition. The State of NT�i 1- <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. <br /> Is nonfriable ACM present iq the structure to be demolished ? [ ] YES [,i]'�10 <br /> If YES complete items 1-9. If NO complete items 3-9. <br /> 1. If ACM will be left in place for the demolition indicate the amount of Category I and/or Category II <br /> nonfriable AC�I left in place. <br /> Categ. I Linear Feet Categ. II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> CateE�I nonfriable A M means asbestos-containing packings, ateporY II nonfriable AGM means any material,ercluding <br /> g�skets,resilient floor covering,and asphalt roofing products Category I nonfriable ACh1,containing more than one percent <br /> containing more than one percent asbestos. asbestos that,when dry,cannot be crumbled,pu(verized,or <br /> `Category I nonfriable AC1I 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. (ez transite,cement,slate roofing) <br /> 2. Description & Location of ACM remaining in place (including floor# and room #): <br />