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0 <br />Notification Case *: 202003698 <br />This page must be printed. A printout of the notification, all amendments to the notification, and the asbestos survey shall be available for inspection at all <br />times at the asbestos project or demolition site (Reg III, 4.03(a)(6)). <br />Fee Amount Paid $65.00 <br />Credit Card Transaction ¢ AR1A68543260 <br />Transaction Date <br />08/25/20 <br />Owner's Name <br />Ride tlardt <br />Project Street Address 1023 110th St. SW <br />City <br />Everett <br />Contact Person <br />Rick Nardt <br />Flailing Address <br />7714 78th PI NE <br />Marysville, WA 98270 <br />Phone (425)330-6753 <br />Zip 98204 <br />Phone (425) 330-6753 <br />This project includes a demolition. <br />Demolition Start Date 09/07/20 Completion Date 12/31/20 <br />Demolition will be completed by a demolition contractor <br />Demo Contractor Property Ovrner Contractor lob <br />Contact Phone <br />Mailing Address <br />(1) I certify that the information I have provided is to the best of my knowledge true and accurate. <br />(2) I understand that I must file an Amendment to this Notification if; <br />• The type of project has changed. The project types are asbestos and demolition. <br />• The quantity of friable asbestos to be removed meets a larger project category. <br />• The projects start or completion date has changed. <br />(3) I understand one Notification must be filed for each structure. The only exception is for a single-family residence that includes multiple ancillary <br />structures, such as a detached garage or other outbuildings having the same street address, if there is no street address, I have used a building number. <br />(4) I understand the fees for this Notification are nonrefundable. <br />Create Another Notification <br />if you have questions, contact us at asbestosCpscleanairorg or 206.689.4058. <br />