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4I3M 0:277 AM Approved Tmnsadon <br />CMAN <br />Clean Air Agency <br />Single -Family Notification Case #: 202301449 <br />This page must be printed, A printout of the nonfiction, all amendments 0 the notification, and the asbestos survey shall be available <br />for Inspection at all limes at the asbestos project Or demolition site (Reg III, 4.03(a)(6)). <br />Fee Amount Paid $65.00 <br />Chose Card Transaction N AROASEB66280 <br />Transaction Date 04/03/23 <br />Owners Name Llberato, Llcla and Linda <br />Phone <br />(425) 218-1280 <br />Project Street Address 3219 W. Mukilteo Blvd <br />City Everett <br />21p <br />98203 <br />Cmtact Person Aaron Glenn <br />Phone <br />(425) 344-9668 <br />Malling Address POHOXB51 <br />Mukilteo, WA 98275 <br />Ibis project Includes a demolltion. <br />Demolition Stott Date 03/O1/23 Comple0oi 03/03/23 <br />Demolition will be completed by a demolition contractor <br />I certify that: <br />(1) TMS is a single-family residence project. The structure is used by one family who awns the property as their domicile. <br />(2) The Information I have provided Is to the best of my knowledge accurate and complete. <br />(3) I understand the fee for this Notification Is nonrefundable. <br />Create Another Notification <br />If you have questions, contact us at asbestostapscleanab.gov or 206.689.4058. <br />helps/Isecarn.psCleapnlrurplAsbesbs/Pppmvedaepx <br />