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� , . . <br /> • Minnesota Pollution Control Agency <br /> Notificat�on of Intent to Perform a Demolition <br /> �� Type of I�1oti�cation [ J Original [ ] Amended [ J Project Cancellation <br /> Uemolition Contractor: Building Information• <br /> Name: CZ'�-�'�-v9,t"!�� Building Name: <br /> Address: c7c..�c.����-L ��i �"' � • � i <br /> - Address/Location:�,=��r' ���Z,,Yt�y`-"�-.. �"�, <br /> Ciry,State,Zip:_ �-�/'��YZ.�1 /,�/'(�' :,`j,j.j'��/ <br /> City,Statc,Zip: /i�fn��✓/7.cvt�� �..�i �j�>;— � County: ,��'-'i�'1/3'L,r2„�'iY� <br /> Contact Pcrson: ��/ `���1� ���'"` " i <br /> Phone Numbcr(s): �.�:.� - t',dd- �� 7 '7.�;,Z, <br /> Phone Number(s): C��Z — � � � � ��=�� A e of Bld cars : 7�, r" ` ,• <br /> S 8•�Y )�sL� Size of Bldg.(sq.ft.): ���C.. <br /> ..� <br /> Number of Floors Including Basement Level(s): __� <br /> Building Owner: <br /> • Present Use of Bldg.: <br /> Namc: ,%r�1�/ s ��.G,�r.� �1� V��-'�J � <br /> _-_ <br /> Prior Use of Bldg.: ��''`i:�`�'-�-��_�"> 'r_'�j� <br /> Address •,>j��',.�i' �`3i:`'�+.; -S v"�C• <br /> Dates when demolition or intentional burninQ <br /> ��, �vill Begin ``? i` & End ��' b <br /> Ciry,State,Zip:_1i�1/��?'Y1c"; /niY�J`�.� /� <br /> �' Notification must be postrnarked or received ten(10)working days <br /> Contact person: ./l�t'�/ �7 CV-L'�J before demolition begins. 'See item�5 for emergency demolitions. <br /> �S�- �y�'- "? '' Boch Be innin and Endin ' <br /> Phone Number(s): � �� -��~ 8� 3 g dates should be amended in writin�as <br /> nzcessary to reflect current project dates. <br /> If there is>260 linear feet or>160 square feet of Regulated Asbestos-Containing Material (RAC1n in the buildine <br /> to be demolished, it must be removed by a licensed asbestos contractor prior to demolition. The State of l�Pi i- <br /> Notice of Intent to Perform an Asbestos Abatement Project must be used to notify for the asbestos removal. <br /> Is nonfriable AC�I present in the structure to be demolished ? [ ] 'YES [�}'�O <br /> If I'ES complete items 1-9. If NO complete items 3-9. <br /> 1. If ACI�I will be left in place for the demolition indicate the amount of Category I and/or Category II <br /> nonfriable AC�II left in place. <br /> Categ.I Linear Feet Categ. II Linear Feet <br /> Square Feet Square Feet <br /> Cubic Feet Cubic Feet <br /> Cateeorv^j nonfriable ACLf ineans asbestos-containing packings, Cate�orv II nonfri�ble A M means any material,excluding <br /> gaske�s,resilient floor covering,and asphalt roofing products Category I nonfriable AC�1,concaining more than one pzrcent <br /> containing more than one percent asbestos. asbestos tha[,when dry,cannot be crumbled,pulverized,or <br /> 'Category I nonfriable?�C11 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 nanfriable AC`I 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 /> Z. Description & Location of AC�I remaining in place (including floor# and room #): <br />