HomeMy WebLinkAboutFile Documents.42 Mining Stock Pkwy.0001.2018 (14).ARBK COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT APPLICATION
MASTER PERMIT: ______________________DATE:___________
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
PROPERTY INFORMATION
___________________________________ _________ ___________________________
______________ ______________ ________________________________________
__________________________________________________________________________________
____________________________________________________________________________________________
_________________________ _______________ __________________________________
________________________ _______________ __________________________________
PERMIT NUMBER: __________________________
Commerical
DƵůƟͲ&ĂŵŝůLJ
^ŝŶŐůĞ&ĂŵŝůLJ
Use of Building Class of Work
New
ĚĚŝƟŽŶ
ůƚĞƌĂƟŽŶRepair
________
Yes
No
Will there be
ĂŶLJƌŽŽĨͬǁĂůů
ƉĞŶĞƚƌĂƟŽŶƐ͍
NOTICE: This permit becomes null and
ǀŽŝĚŝĨǁŽƌŬŽƌĐŽŶƐƚƌƵĐƟŽŶĂƵƚŚŽƌŝnjĞĚ
ŝƐŶŽƚĐŽŵŵĞŶĐĞĚǁŝƚŚŝŶϭϴϬĚĂLJƐ͕Žƌ
ŝĨĐŽŶƐƚƌƵĐƟŽŶŽƌǁŽƌŬŝƐƐƵƐƉĞŶĚĞĚŽƌ
ĂďĂŶĚŽŶĞĚĨŽƌĂƉĞƌŝŽĚŽĨϭϴϬĚĂLJƐĂƚ
ĂŶLJƟŵĞĂŌĞƌǁŽƌŬŝƐĐŽŵŵĞŶĐĞĚ͘
__________________
_________________
__________________
____________________
________________
_________________
__________
PROJECTVALUATION
SQ FT OF WORK AREA
UNIT SQ FT
SQ FT OF LAND-SCAPE WORK
SQ FT OF ROOMS WITH UTILITY WORK
LOT SIZE(SQ FT)
PROJECT DETAILS
DŝdžĞĚͲhƐĞ
IFFR
Tenant FinishĞŵŽůŝƟŽŶ
Change Order
________
ADDRESS UNIT #PARCEL ID #
BLOCK TRACT OR SUBDIVISIONLOT
DESCRIPTION OF WORK IN DETAIL
FOR CITY USE ONLY
Plan Check Permit Fee Parks Impact
ŶĞƌŐLJŽĚĞ REMP School Ded.
Zoning (50%) Plan Check
;,ŽƵƌůLJͿ
TDM Impact
Engineering Review ŽŶŝŶŐ;,ŽƵƌůLJͿ WĞĚ͘ŵĞŶŝƚLJ
CMP (50%) Engineering
;,ŽƵƌůLJͿ
Housing Cash in Lieu
Parks Review Zoning (50%) Stormwater
hƟůŝƚLJZĞǀŝĞǁ CMP (50%)ŝƚLJhƐĞdĂdž
Other Electrical ŽƵŶƚLJhƐĞdĂdž
Plumbing GIS
Mechanical ^ĂŶŝƚĂƟŽŶ
SUBMITTAL FEES ISSUANCE FEES
__________________PLANS LOCATION
_________Lot Area
_________Zone District
_________Deed Restricted
_________Census Code
_________# of Dwellings
APPROVALS
ISSUANCE FEES
BEST CONTACTNAME CELL EMAIL
OWNER NAME CELL EMAIL
____Toilets, Bidets
____Bathtub
ͺͺͺͺ>ĂǀĂƚŽƌLJ;tĂƐŚĂƐŝŶͿ
____Shower
____Kitchen Sink (+Disposal)
____Dishwasher
ͺͺͺͺ>ĂƵŶĚƌLJĂƌ͕hƟůŝƚLJ^ŝŶŬ
____Clothes Washer
____Floor Sink
____Floor Drain
____Shower
____Water Heater (Pan Req)
____# Gas Outlets
____Water Treatment
____Other_________
Fixture Counts
____&ŽƌĐĞĚŝƌͬ'ƌĂǀŝƚLJ^LJƐƚĞŵƐ
____Wall, Suspended, or Unit Heaters
____Gas Log
____Gas Appliancew
____Appliance Vents
____Heat, Refrig, Cooling, or
ďƐŽƌƉƟŽŶhŶŝƚ
____Boilers (includes vent)
____Air Handling Unit
ͺͺͺͺŽŽůŝŶŐ^LJƐƚĞŵƐ
ͺͺͺͺsĞŶƟůĂƟŽŶ&ĂŶƐ
____Range Hood
ͺͺͺͺηŽĨ'ĂƐ^LJƐƚĞŵKƵƚůĞƚƐ
____^ŶŽǁŵĞůƚ^LJƐƚĞŵ^Ƌ&ƚͺͺͺͺͺͺͺͺͺ
Equipment Checklist
Zoning
HPC
Building
Fire
Engineering
CMP
hƟůŝƟĞƐ
Water
Stormwater
^ĂŶŝƚĂƟŽŶ
Env. Health
Parks
Landscape
ĸĐŝĞŶĐLJ
Approved
To Issue
Issuance
ReviewRequired Date ApprovedReviewingDepartmentReviewer/ŶŝƟĂůƐ
ĂůůƐƐĞƐƐŽƌ;ϵϳϬͲϵϮϬͲϱϭϲϬͿƚŽǀĞƌŝĨLJ
NEW SQ FT
ĞƚĂŝůƐdĞƌŵĞĮŶŝƟŽŶƐ
WƌŽũĞĐƚsĂůƵĂƟŽŶ͗ŽƐƚŽĨƉƌŽũĞĐƚĂƐĚĞĮŶĞĚŝŶsĂůƵĂƟŽŶīĂĚĂǀŝƚ͘
^Ƌ&ƚŽĨtŽƌŬƌĞĂ͗dŽƚĂůƐƋƵĂƌĞĨŽŽƚĂŐĞŽĨĂƌĞĂƵŶĚĞƌŐŽŝŶŐĐŚĂŶŐĞŽƌƌĞĐŽŶĮŐƵƌĂƟŽŶ͘
hŶŝƚ^Ƌ&ƚ͗'ƌŽƐƐ^ƋƵĂƌĞ&ŽŽƚĂŐĞ͕ŶŽƚ&Z͕ŽĨƉĞƌŵŝƩĞĚƵŶŝƚ͘
>Žƚ^ŝnjĞ͗dŽƚĂůƐƵƌǀĞLJĞĚƐƋƵĂƌĞĨŽŽƚĂŐĞŽĨƉƌŽƉĞƌƚLJ͘
Sq Ft of Landscape Work: Square footage of disturbed exterior area.
EĞǁ^Ƌ&ƚ͗dŽƚĂůĂĚĚĞĚƐƋƵĂƌĞĨŽŽƚĂŐĞĨŽƌĂĚĚŝƟŽŶƐƚŽŶĞƚůŝǀĂďůĞŽƌŶĞƚůĞĂƐďůĞƐƉĂĐĞ͘
^Ƌ&ƚŽĨZŽŽŵƐǁŝƚŚhƟůŝƚLJtŽƌŬ͗dŽƚĂůƐƋƵĂƌĞĨŽŽƚĂŐĞ͕ŶŽƚ&Z͕ŽĨĂůůƌŽŽŵƐǁŝƚŚƉůƵŵďŝŶŐǁŽƌŬ͘
KzKh>/<K'^͍
ƵŐƵƐƚϮϬϭϳ
01/08/2018
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ĂƟŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŶŶ &Ă&Ă&Ă&&Ă&&ĂĂ&Ă&Ă&Ă&Ă&Ă&Ă&Ă&&Ă&Ă&Ă&&&Ă&&Ă&&Ă&&&Ă&Ă&&&&&&Ă&&Ă&&&&Ă&&&&&&&&&&&Ă&&&ĂĂĂĂ&ŶƐŶƐŶŶƐŶƐƐŶƐŶƐƐŶƐŶƐƐƐŶƐƐŶƐŶŶƐƐƐƐƐŶƐŶŶŶƐƐƐ
TF 1/25/18
TF 1/25/18
0001.2018.ARBK
42 Mining Stock Parkway 107 273502312012
Expansion/Addition to an existing storage space, replacement of roof and new supporting walls, new windows and interior finish.
Bob McDonough 970.379.9674 mcdonoughconstruction@comcast.net
Ian Metcalf 970.319.9525 mettie07@gmail.com
27500.00 000000
79
1774
000
1853
N/A
000000
x cs 3.22.18
0
0
48.19
N/A
0
AH/PD
DM 3/2 6yes
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING PERMIT CONTACT SHEET
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
City
Mailing Address
E-mailAddress
State ZIP
OWNER
___________________________________ _____________________ ________________________Name Phone E-mail
FOR PLAN REVIEW QUESTIONS
___________________________________ _____________________ ________________________Name Phone E-mail
FOR INSPECTION QUESTIONS
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
City
Mailing Address
E-mailAddress
State ZIP
OWNER’S AUTHORIZED AGENT
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
City
Mailing Address
E-mailAddress
State ZIP
APPLICATION BEST CONTACT
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
CityMailing Address
E-mailAddress
State ZIP
ARCHITECT OR DESIGNER OF RECORD
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
CityMailing Address
E-mailAddress
State ZIP
CIVIL ENGINEER OF RECORD
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
City
Mailing Address
E-mailAddress
State ZIP
STRUCTUAL ENGINEER OF RECORD
/ŚĞƌĞďLJĐĞƌƟĨLJƚŚĂƚ/ŚĂǀĞƌĞĂĚĂŶĚĞdžĂŵŝŶĞĚƚŚŝƐĂƉƉůŝĐĂƟŽŶĂŶĚŬŶŽǁƚŚĞƐĂŵĞƚŽďĞƚƌƵĞĂŶĚĐŽƌƌĞĐƚ͘ůůƉƌŽǀŝƐŝŽŶƐŽĨůĂǁƐĂŶĚ
ŽƌĚŝŶĂŶĐĞƐŐŽǀĞƌŶŝŶŐƚŚŝƐƚLJƉĞŽĨǁŽƌŬǁŝůůďĞĐŽŵƉůŝĞĚǁŝƚŚǁŚĞƚŚĞƌƐƉĞĐŝĮĞĚŚĞƌĞŝŶŽƌŶŽƚ͘dŚĞŐƌĂŶƟŶŐŽĨĂƉĞƌŵŝƚĚŽĞƐŶŽƚ
ƉƌĞƐƵŵĞƚŽŐŝǀĞĂƵƚŚŽƌŝƚLJƚŽǀŝŽůĂƚĞŽƌĐĂŶĐĞůƚŚĞƉƌŽǀŝƐŝŽŶƐŽĨĂŶLJŽƚŚĞƌƐƚĂƚĞŽƌůŽĐĂůůĂǁƌĞŐƵůĂƟŶŐĐŽŶƐƚƌƵĐƟŽŶŽƌƚŚĞƉĞƌĨŽƌŵĂŶĐĞ
ŽĨĐŽŶƐƚƌƵĐƟŽŶ͘/ƚŝƐŵLJƌĞƐƉŽŶƐŝďŝůŝƚLJƚŽƌĞǀŝĞǁƚŚĞĂƉƉƌŽǀĞĚƉůĂŶƐĂŶĚĂŶLJĐŽŵŵĞŶƚƐƚŚĂƚĂƌĞĐŽŶƚĂŝŶĞĚƚŚĞƌĞŽŶĂŶĚƐĞĞƚŚĂƚƚŚĞ
ƐƚƌƵĐƚƵƌĞĂŶĚͬŽƌƉƌŽũĞĐƚŝƐďƵŝůƚŝŶĐŽŵƉůŝĂŶĐĞǁŝƚŚĂůůĂƉƉůŝĐĂďůĞĐŽĚĞƐ͘
________________________________________________________ _____________________ContractorSignature Date
/E^Wd/KE^͗dŚĞ'ĞŶĞƌĂůŽŶƚƌĂĐƚŽƌŵƵƐƚƐĐŚĞĚƵůĞŝŶƐƉĞĐƟŽŶƐŽŶůŝŶĞ͘
WůĞĂƐĞǀŝƐŝƚǁǁǁ͘ĂƐƉĞŶƉŝƚŬŝŶ͘ĐŽŵͬĞƉĂƌƚŵĞŶƚƐͬŽŵŵƵŶŝƚLJͲĞǀĞůŽƉŵĞŶƚͲ&ŽƌŵƐͬƚŽĚŽƐŽ͘
___________________________________ _____________________ _____________________
________________________________________ __________________ _________ ____________
_______________________________________________________________________________________
Name Phone Cell Phone
CityMailing Address
E-mailAddress
State ZIP
GENERAL CONTRACTOR
ŚĞĐŬŝĨLJŽƵĂƌĞĂƚĞƐƚĞĚŽǁŶĞƌďƵŝůĚĞƌ;ƐŝŶŐůĞͲĨĂŵŝůLJŚŽŵĞƐŽŶůLJͿ͘zŽƵŵƵƐƚƚĂŬĞĂƚĞƐƚĂŶĚĐŽŵƉůĞƚĞƚŚĞŽǁŶĞƌͬďƵŝůĚŝŶŐĂĸĚĂǀŝƚ͘
;/dzh^KE>zͿKǁŶĞƌďƵŝůĚĞƌĂƉƉƌŽǀĞĚďLJ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĂƚĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĸĚĂǀŝƚŽŶĮůĞ
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
August 2017
01/08/2018
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Juan Lagarrigue 970.987.3216 jlagarrigue@manchester-architects.com
Bob McDonough 970.379.9674 mcdonoughconstruction@comcast.net
Ian Metcalf 970.319.9525
42 Mining Stock Pkwy #107 Aspen CO 81611
mettie07@gmail.com
Manchester Architects - Juan Lagarrigue PM 970.923.4411 x15 970.987.3216
PO Box 6573 Snowmass Village CO 81615
jlagarrigue@manchester-architects.com
Hein Brutsaert PE 970.300.1003
133 Prospector Rd. Unit 4102R Aspen CO 81611
Bob Mc Donough 970.379.9674
PO Box 11689 Aspen CO 81612
mcdonoughconstruction@comcast.net
Juan Lagarrigue Digitally signed by Juan Lagarrigue
Date: 2017.12.16 12:01:36 -07'00'2017.12.16
COMMUNITY DEVELOPMENT DEPARTMENT
SCOPE OF WORK CHECKLIST
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
/ĨLJŽƵĐŚĞĐŬĂŶLJŽĨƚŚĞďŽdžĞƐďĞůŽǁ͕ƉůĞĂƐĞĐŽŶƐƵůƚǁŝƚŚƚŚĞWůĂŶŶĞƌŽĨƚŚĞĂLJ;ƉůĂŶŶĞƌŽŌŚĞĚĂLJΛŐŵĂŝů͘ĐŽŵͿďĞĨŽƌĞƐƵďŵŝƫŶŐLJŽƵƌ
ƉĞƌŵŝƚĂƉƉůŝĐĂƟŽŶ͘
ŽĞƐLJŽƵƌƉĞƌŵŝƚŝŶǀŽůǀĞĂŶLJŽĨƚŚĞĨŽůůŽǁŝŶŐ͍
LAND USE QUESTIONS
ADDRESS: ____________________________PERMIT NUMBER: _______________________________
WĂƌƚŽĨĂŶĂƉƉƌŽǀĞĚK>ĂŶĚhƐĞZĞǀŝĞǁ
tŽƌŬĂīĞĐƚƐŶĞƚůĞĂƐĂďůĞ͕ŶĞƚůŝǀĂďůĞ͕Žƌ
non-unit space
tŽƌŬŝŶǀŽůǀĞƐůŽƚƐƉůŝƫŶŐŽƌĐŽŵďŝŶŝŶŐĂůŽƚ
tŽƌŬŝŶǀŽůǀĞƐĞdžƚĞƌŝŽƌŽĨƐƚƌƵĐƚƵƌĞ
ŚĂŶŐŝŶŐƚŚĞŶƵŵďĞƌŽĨƌĞƐŝĚĞŶƟĂůƵŶŝƚƐ
ŚĂŶŐĞƐƚŽŶƵŵďĞƌŽƌůŽĐĂƟŽŶŽĨ
ŽŶƐŝƚĞƉĂƌŬŝŶŐ
tŽƌŬŝŶǀŽůǀĞƐ>ĂŶĚŵĂƌŬWĂƌĐĞůŽƌ,ŝƐƚŽƌŝĐŝƐƚƌŝĐƚ
>ŽĐĂƚĞĚŝŶϭϬϬͲLJĞĂƌŇŽŽĚƉůĂŝŶŽƌǁŝƚŚŝŶϭϬϬ͛ŽĨŚŝŐŚ
ǁĂƚĞƌŵĂƌŬ
tŽƌŬŝŶǀŽůǀĞƐĐŚĂŶŐĞƐŝŶŽĐĐƵƉĂŶĐLJƚŽƐƚƌƵĐƚƵƌĞ
ŚĂŶŐĞƐƚŽĞůĞǀĂƚŽƌŽƌƐƚĂŝƌĐŽŶĮŐƵƌĂƟŽŶ
ŚĂŶŐĞƐƚŽƚŚĞƵƐĞŽĨĞdžŝƐƟŶŐƐƚƌƵĐƚƵƌĞŽƌƐƉĂĐĞ
ŽĞƐLJŽƵƌƉĞƌŵŝƚŝŶǀŽůǀĞĂŶLJŽĨƚŚĞĨŽůůŽǁŝŶŐ͍
ADDITIONAL SCOPE OF WORK QUESTIONS
džƚĞƌŝŽƌůŝŐŚƟŶŐĂĚĚĞĚŽƌĐŚĂŶŐĞĚ
tŽƌŬŝŶǀŽůǀĞƐƌŽŽĨƉĞŶĞƚƌĂƟŽŶƐ
tŽƌŬĂĚĚƐ͕ƌĞŵŽǀĞƐ͕ŽƌĐŚĂŶŐĞƐ
ƉůƵŵďŝŶŐĮdžƚƵƌĞƐ
ŝƐƚƵƌďƐϭ͕ϬϬϬƐƋŌŽƌŵŽƌĞŽĨƐŽŝůǁŝƚŚŝŶ
ϭϮŵŽŶƚŚƐ
tŽƌŬŽĐĐƵƌƐŝŶƉƵďůŝĐƌŝŐŚƚŽĨǁĂLJ
tŽƌŬĂīĞĐƚƐƚƌĞĞƐŽƌŽĐĐƵƌƐǁŝƚŚŝŶƚŚĞ
ĚƌŝƉůŝŶĞŽĨĂƚƌĞĞ
tŽƌŬŝŶǀŽůǀĞƐĞdžƚĞƌŝŽƌǁĂůůƉĞŶĞƚƌĂƟŽŶƐ
tŽƌŬŝŶǀŽůǀĞƐĚŝŐŐŝŶŐŽƌĞdžĐĂǀĂƟŽŶ
tŽƌŬŝŶǀŽůǀĞƐƌĞƐƚĂƵƌĂŶƚŽƌĨŽŽĚƐĞƌǀŝĐĞ
īĞĐƚƐƉĂƌŬŝŶŐƐƉĂĐĞƐͬŵĞƚĞƌƐ͕ůŽĂĚŝŶŐnjŽŶĞƐ͕ŽƌĂůůĞLJƐ
ĚĚŝŶŐƐƚƌƵĐƚƵƌĞƐŽƌƐLJƐƚĞŵƐŽǀĞƌƵƟůŝƚLJůŝŶĞƐ
tŽƌŬǁŝƚŚŝŶŝƚLJDĂůůďŽƵŶĚĂƌŝĞƐ
August 2017
01/08/2018
ƟŽŶƐ
Ŷ
ŽĚĞĚŝƟŽŶƐ
&ŝƌĞ^ƉƌŝŶŬůĞƌ^LJƐƚĞŵ
dLJƉĞKĨŽŶƐƚƌƵĐƟŽŶ&ŝƌĞůĂƌŵƐ/ŶƐƚĂůůĞĚ
ZĞƋƵŝƌĞĚ^ƉĞĐŝĂů/ŶƐƉĞĐƟŽŶƐ
ŶĞƌŐLJŽĚĞŽŵƉůŝĂŶĐĞ
džƚĞƌŝŽƌŶĞƌŐLJhƐĞ dŽƚĂůƉƉƌŽǀĞĚKŶͲ^ŝƚĞ^ŶŽǁŵĞůƚͺͺͺͺͺͺͺͺ^ƉĂͺͺͺͺͺͺͺWŽŽůͺͺͺͺͺͺͺͺͺ
ƵŝůĚŝŶŐdLJƉĞͬKĐĐƵƉĂŶĐLJ'ƌŽƵƉ
KDDhE/dzs>KWDEdWZdDEd
BUILDING DESCRIPTION FORM - IRC & IBC
/dzK&^WE ϭϯϬ^͘'>E^dͮ^WE͕Kϴϭϲϭϭ
BUILDING CODE INFORMATION
ϮϬϭϱ/Z
džŝƐƟŶŐ͍E&Wϭϯ E&WϭϯZ
,ŝŐŚͲ^ƚƌĞŶŐƚŚŽůƟŶŐ ƉŽdžLJŶĐŚŽƌƐ ^ƚƌƵĐƚƵĂů^ƚĞĞůtĞůĚŝŶŐ
WĞƌŵĂŶĞŶƚDŝĐƌŽƉŝůĞƐ KƚŚĞƌͺͺͺͺͺͺͺͺͺͺͺͺͺ
WƌĞƐĐƌŝƉƟǀĞdĂďůĞ
UNIT DESCRIPTION AS PROPOSED
η^ƚŽƌŝĞƐďŽǀĞ'ƌĂĚĞͺͺͺͺͺͺ η^ƚŽƌŝĞƐĞůŽǁ'ƌĂĚĞͺͺͺͺͺͺͺ
WĂƌŬŝŶŐ^ƉĂĐĞƐͺͺͺͺͺͺWĂƌŬŝŶŐ^ƉĂĐĞƐͺͺͺͺͺͺWĂƌŬŝŶŐ^ƉĂĐĞƐͺͺͺͺͺͺ
ηĞĚƌŽŽŵƐͺͺͺͺͺͺ η&ƵůůĂƚŚƐͺͺͺͺͺͺĞĐŬƌĞĂͺͺͺͺͺͺ
ηϯͬϰĂƚŚƐͺͺͺͺͺͺ ηϭͬϮĂƚŚƐͺͺͺͺͺͺ
η<ŝƚĐŚĞŶƐͺͺͺͺͺͺ ηtŽŽĚ&ŝƌĞƉůĂĐĞƐͺͺͺͺͺͺ
η'ĂƐƉƉůŝĂŶĐĞƐͺͺͺͺͺͺ η'ĂƐ>ŽŐƐͺͺͺͺͺͺ
E&Wϭϯ
Z^ŚĞĐŬhůƚĞƌŶĂƟǀĞ
zĞƐ EŽ
KŶĞ&ĂŵŝůLJ dǁŽ&ĂŵŝůLJ
dŽǁŶŚŽƵƐĞ
ZĞǀŝǁĞĚLJ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĂƚĞ͗ͺͺͺͺͺͺͺͺͺͺ
BUILDING ROOMS AND USES BY LEVEL AS PROPOSED (Include Mechanical & Storage)
ĂƐĞŵĞŶƚͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
DĂŝŶ>ĞǀĞůͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ϮŶĚ&ůŽŽƌͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ϯƌĚ&ůŽŽƌͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ĚĚŝƟŽŶĂůͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ƩĂĐŚĞĚ'ĂƌĂŐĞ ĞƚĂĐŚĞĚ'ĂƌĂŐĞ ĂƌƉŽƌƚ
/ƐƚŚĞƌĞĂŶh͍
η>ŝǀŝŶŐZŽŽŵƐͺͺͺͺͺ
η<ŝƚĐŚĞŶƐ ͺͺͺͺͺ
η&ƵůůĂƚŚƐ ͺͺͺͺͺ
ηϯͬϰĂƚŚƐ ͺͺͺͺͺ
ηϭͬϮĂƚŚƐ ͺͺͺͺͺ
ηĞĚƌŽŽŵƐ ͺͺͺͺͺ
ηKƚŚĞƌZŽŽŵƐ;>ŝƐƚͿͺͺͺͺͺͺͺͺͺͺͺͺ
ADU BUILDING DESCRIPTION
zĞƐ
EŽ
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
;ƐĚŽƉƚĞĚĂŶĚŵĞŶĚĞĚͿ
KƚŚĞƌ;WůĞĂƐĞdžƉůĂŝŶͿ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ss/s ////////////
^ƉƌĂLJĞĚ&ŝƌĞͲZĞƐŝƐƚĂŶƚƐ
KDŚĞĐŬhůƚĞƌŶĂƟǀĞ
;džŝƐƟŶŐнEĞǁͿ
ͺͺ B
;фϱϬͿ
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D
I
R
C
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ϮϬϭϱ/
;ƐĚŽƉƚĞĚĂŶĚŵĞŶĚĞĚͿ
zĞƐ
EŽ ZĞƋƵŝƌĞĚ͍zĞƐ
EŽ dLJƉĞ
August 2017
01/08/2018
ͺͺͺ
EŽ
2
20
000
320
00
10
10
Living/Dining Room, 1 Bedroom, 1 Full Bathroom, Mechanical room, storage, laundry rm.
2 Bedrooms, 1 Full Bathroom, 1 Office/Den (New)
COMMUNITY DEVELOPMENT DEPARTMENT
HOMEOWNER ASSOCIATION COMPLIANCE FORM
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
ůůĂƉƉůŝĐĂƟŽŶƐĨŽƌĂďƵŝůĚŝŶŐƉĞƌŵŝƚǁŝƚŚŝŶƚŚĞŝƚLJŽĨƐƉĞŶĂƌĞƌĞƋƵŝƌĞĚƚŽŝŶĐůƵĚĞĂĐĞƌƟĮĐĂƟŽŶŽĨĐŽŵƉůŝĂŶĐĞ
ǁŝƚŚĂƉƉůŝĐĂďůĞĐŽǀĞŶĂŶƚƐĂŶĚŚŽŵĞŽǁŶĞƌĂƐƐŽĐŝĂƟŽŶƉŽůŝĐŝĞƐ͘dŚĞĐĞƌƟĮĐĂƟŽŶŵƵƐƚďĞƐŝŐŶĞĚďLJƚŚĞƉƌŽƉĞƌƚLJ
ŽǁŶĞƌŽƌƵƚŚŽƌŝnjĞĚŐĞŶƚƌĞƉƌĞƐĞŶƟŶŐƚŚĞƉƌŽƉĞƌƚLJŽǁŶĞƌ͘dŚĞĨŽůůŽǁŝŶŐĐĞƌƟĮĐĂƟŽŶƐŚĂůůĂĐĐŽŵƉĂŶLJƚŚĞ
ĂƉƉůŝĐĂƟŽŶĨŽƌĂƉĞƌŵŝƚ͘
___________________________________ _________ ___________________________
/͕ƚŚĞƉƌŽƉĞƌƚLJŽǁŶĞƌ͕ĐĞƌƟĨLJĂƐĨŽůůŽǁƐ͗;ƉŝĐŬŽŶĞͿ
dŚŝƐƉƌŽƉĞƌƚLJŝƐŶŽƚƐƵďũĞĐƚƚŽĂŚŽŵĞŽǁŶĞƌ͛ƐĂƐƐŽĐŝĂƟŽŶŽƌŽƚŚĞƌĨŽƌŵŽĨƉƌŝǀĂƚĞĐŽǀĞŶĂŶƚ͘
dŚŝƐƉƌŽƉĞƌƚLJŝƐƐƵďũĞĐƚƚŽĂŚŽŵĞŽǁŶĞƌƐĂƐƐŽĐŝĂƟŽŶŽƌƉƌŝǀĂƚĞĐŽǀĞŶĂŶƚĂŶĚƚŚĞŝŵƉƌŽǀĞŵĞŶƚƐ
ƉƌŽƉŽƐĞĚŝŶƚŚŝƐďƵŝůĚŝŶŐƉĞƌŵŝƚĚŽŶŽƚƌĞƋƵŝƌĞĂƉƉƌŽǀĂůďLJƚŚĞŚŽŵĞŽǁŶĞƌƐĂƐƐŽĐŝĂƟŽŶŽƌĐŽǀĞŶĂŶƚ
ďĞŶĞĮĐŝĂƌLJ͘
dŚŝƐƉƌŽƉĞƌƚLJŝƐƐƵďũĞĐƚƚŽĂŚŽŵĞŽǁŶĞƌƐĂƐƐŽĐŝĂƟŽŶŽƌƉƌŝǀĂƚĞĐŽǀĞŶĂŶƚĂŶĚƚŚĞŝŵƉƌŽǀĞŵĞŶƚƐ
ƉƌŽƉŽƐĞĚŝŶƚŚŝƐďƵŝůĚŝŶŐƉĞƌŵŝƚŚĂǀĞďĞĞŶĂƉƉƌŽǀĞĚďLJƚŚĞŚŽŵĞŽǁŶĞƌƐĂƐƐŽĐŝĂƟŽŶŽƌĐŽǀĞŶĂŶƚďĞŶĞĮĐŝĂƌLJ͘
/ƵŶĚĞƌƐƚĂŶĚƚŚĞŝƚLJŽĨƐƉĞŶĚŽĞƐŶŽƚŝŶƚĞƌƉƌĞƚ͕ĞŶĨŽƌĐĞ͕ŽƌŵĂŶĂŐĞƚŚĞĂƉƉůŝĐĂďŝůŝƚLJ͕ŵĞĂŶŝŶŐŽƌĞīĞĐƚŽĨ
ƉƌŝǀĂƚĞĐŽǀĞŶĂŶƚƐŽƌŚŽŵĞŽǁŶĞƌĂƐƐŽĐŝĂƟŽŶƌƵůĞƐŽƌďLJůĂǁƐ͘/ƵŶĚĞƌƐƚĂŶĚƚŚĂƚƚŚŝƐĚŽĐƵŵĞŶƚŝƐĂƉƵďůŝĐ
ĚŽĐƵŵĞŶƚ͘
KǁŶĞƌ^ŝŐŶĂƚƵƌĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ ĂƚĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
KǁŶĞƌWƌŝŶƚĞĚEĂŵĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
OR
ƵƚŚŽƌŝnjĞĚŐĞŶƚ^ŝŐŶĂƚƵƌĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ ĂƚĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ƵƚŚŽƌŝnjĞĚŐĞŶƚWƌŝŶƚĞĚEĂŵĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ADDRESS UNIT #PARCEL ID #
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
August 2017
01/08/2018
ŽǀĞŵĞŶƚƐ
ĂŶƚŶƚŶƚŶŶƚŶŶƚŶƚŶƚŶƚŶƚŶƚŶƚŶŶƚŶŶƚŶƚŶŶŶŶŶƚŶŶŶƚŶƚŶƚŶƚŶƚŶƚŶƚƚŶŶƚƚƚŶƚŶƚƚŶƚŶƚŶƚŶŶŶŶŶŶŶŶŶŶƚƚƚƚŶŶƚ ďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďďĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶŶŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶŶĞŶĞŶĞŶĞŶŶŶĞŶĞĞĞŶĞĞĞŶĞŶŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞŶĞĞŶĞŶĞĞĞĞŶŶĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĮĞĞĞĮĞĮĞĮĞĮĞĮĞĞĮĞĮĮĮĞĮĞĞĮĮĮĮĞĞĮĮĮĮĞĮĮĮĞĮĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐĐĐŝĐŝĐĐĐĐĐĐĐĐĐĐĐŝŝĐĐĐĐĐŝĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐŝĐĐŝŝŝŝĂƌĂƌĂƌĂƌĂƌĂƌĂƌĂƌĂƌĂƌƌƌĂƌĂƌƌƌƌĂƌĂĂĂƌƌĂƌĂƌĂĂĂĂƌĂƌĂƌĂƌĂƌĂƌĂƌĂĂƌĂƌĂƌĂƌĂĂĂƌĂĂĂƌLJ͘LJ͘LJLJ͘LJ͘LJ͘LJ͘LJ͘LJLJ͘LJ͘LJ͘LJ͘LJ͘LJLJLJ͘LJLJLJLJLJ͘LJLJ͘LJ͘LJLJLJ͘LJ͘LJ͘LJ͘LJLJLJ͘LJLJ͘LJ͘LJ͘LJ͘LJ͘LJLJ͘LJ͘LJ͘LJLJ͘LJ͘
ŶŐ ŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌƌ ĞīĞīĞīĞīĞīĞīĞīĞīĞīĞīĞīīĞīīīīĞīĞīĞīĞīĞīĞīĞīĞĞīĞīĞīīīīĞīĞīĞīīīĞīīĞīīĞīĞīĞīīĞīīĞīĞīĞīĞīīĞīĞĞīĞīīīīĞīĞīĞīīīīīĞīīīīĞĞīĞīĞīĞīīīĞīīīīĞīīĞīīĞīĞīīĞīīīīīīīīīīīīīīīīĞīīīīīīīĞīĞīĞīĞĞīīīĞīīīĞĞīĞīĞīĞĐĞĐĞĐĞĐĞĞĞĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĐĞĞĐĞĐĞĐĐĞĐĞĐĞĞĞĐĞĐĞĞĐĐĞĐĐĐĞĐĐĞĐĐĞĞĐĞĞĞĐĞĐĞĐĐĐĞĞĐĞĐĞĞĞĞĞĐĐĞĐĞĐĞĞĐĞĞĐĐĐĞĞĞĞĞĐĐĞĞĞĞĐĞĞĞĐĐĞĐĞĞĞĐĞĐĞĞĞĐĐĞĐĞĞĐĐĐĞĞĞĐĐĐĐĐĐĞĐĞĐĐĐĐĞĞĞĐĞĞĞƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚ ŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽŽĨŽĨĨĨŽĨŽĨĨĨŽĨŽĨŽĨŽĨŽĨĨĨĨŽŽŽŽĨĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽĨŽŽĨĨĨŽĨŽĨŽĨŽĨŽĨĨĨŽĨŽŽŽĨŽŽĨŽĨŽŽĨĨĨĨŽĨŽĨĨĨĨŽĨŽŽŽĨŽĨŽĨŽŽŽĨŽĨŽĨŽĨŽŽĨŽĨĨŽĨĨŽĨŽĨŽĨŽĨŽĨĨŽŽŽŽŽŽĨŽŽŽĨĨĨŽŽŽŽĨĨŽŽŽĨĨĨĨĨŽŽŽŽŽĨĨŽŽŽŽŽĨĨ
ƚ ŝ ďůŝ
42 Mining Stock Pkwy 107 273502312012
X
Juan Lagarrigue
Digitally signed by Juan
Lagarrigue
Date: 2017.12.16 12:11:45
-07'00'
COMMUNITY DEVELOPMENT DEPARTMENT
VALUATION AFFADAVIT
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
ůůĂƉƉůŝĐĂƟŽŶƐĨŽƌĂďƵŝůĚŝŶŐƉĞƌŵŝƚǁŝƚŚŝŶƚŚĞŝƚLJŽĨƐƉĞŶĂƌĞƌĞƋƵŝƌĞĚƚŽŝŶĐůƵĚĞĂĐĞƌƟĮĐĂƟŽŶŽĨ
ĐŽŵƉůŝĂŶĐĞǁŝƚŚďƵŝůĚŝŶŐƉĞƌŵŝƚǀĂůƵĂƟŽŶƌĞƋƵŝƌĞŵĞŶƚƐ͘dŚĞĐĞƌƟĮĐĂƟŽŶŵƵƐƚďĞƐŝŐŶĞĚďLJƚŚĞƉƌŽƉĞƌƚLJ
ŽǁŶĞƌŽƌĂƵƚŚŽƌŝnjĞĚƌĞƉƌĞƐĞŶƚĂƟǀĞ͘dŚĞĨŽůůŽǁŝŶŐĐĞƌƟĮĐĂƟŽŶƐŚĂůůĂĐĐŽŵƉĂŶLJƚŚĞĂƉƉůŝĐĂƟŽŶĨŽƌĂƉĞƌŵŝƚ͘
/͕ƚŚĞƉƌŽƉĞƌƚLJŽǁŶĞƌŽƌĂƵƚŚŽƌŝnjĞĚĂŐĞŶƚ͕ƵŶĚĞƌƐƚĂŶĚĂŶĚĐĞƌƟĨLJĂƐĨŽůůŽǁƐ͗
ŝƚLJŽĨƐƉĞŶKƌĚŝŶĂŶĐĞEŽ͘ϰϬ͕^ĞƌŝĞƐŽĨϮϬϭϲĂĚŽƉƚƐƚŚĞϮϬϭϱ/ŶƚĞƌŶĂƟŽŶĂůZĞƐŝĚĞŶƟĂůŽĚĞ;/ZͿĂŶĚ
/ŶƚĞƌŶĂƟŽŶĂůƵŝůĚŝŶŐŽĚĞ;/ͿǁŝƚŚĐĞƌƚĂŝŶĂŵĞŶĚŵĞŶƚƐ͘dŚĞƐĞĐŽĚĞƐĚĞĮŶĞďƵŝůĚŝŶŐǀĂůƵĂƟŽŶĂƐĨŽůůŽǁƐ͗
ZϭϬϴ͘ϯƵŝůĚŝŶŐƉĞƌŵŝƚǀĂůƵĂƟŽŶƐ͘ƵŝůĚŝŶŐƉĞƌŵŝƚǀĂůƵĂƟŽŶƐŚĂůůŝŶĐůƵĚĞƚŽƚĂůǀĂůƵĞŽĨƚŚĞǁŽƌŬĨŽƌǁŚŝĐŚĂ
ƉĞƌŵŝƚŝƐďĞŝŶŐŝƐƐƵĞĚ͕ƐƵĐŚĂƐĞůĞĐƚƌŝĐĂů͕ŐĂƐ͕ŵĞĐŚĂŶŝĐĂů͕ƉůƵŵďŝŶŐĞƋƵŝƉŵĞŶƚ͕ĂŶĚŽƚŚĞƌƉĞƌŵĂŶĞŶƚƐLJƐƚĞŵƐ͕
ŝŶĐůƵĚŝŶŐŵĂƚĞƌŝĂůƐĂŶĚůĂďŽƌ͘
ϭϬϵ͘ϯƵŝůĚŝŶŐƉĞƌŵŝƚǀĂůƵĂƟŽŶƐ͘dŚĞĂƉƉůŝĐĂŶƚĨŽƌĂƉĞƌŵŝƚƐŚĂůůƉƌŽǀŝĚĞĂŶĞƐƟŵĂƚĞĚƉĞƌŵŝƚǀĂůƵĞĂƚƟŵĞ
ŽĨĂƉƉůŝĐĂƟŽŶ͘WĞƌŵŝƚǀĂůƵĂƟŽŶƐƐŚĂůůŝŶĐůƵĚĞƚŽƚĂůǀĂůƵĞŽĨǁŽƌŬ͕ŝŶĐůƵĚŝŶŐŵĂƚĞƌŝĂůƐĂŶĚůĂďŽƌ͕ĨŽƌǁŚŝĐŚƚŚĞ
ƉĞƌŵŝƚŝƐďĞŝŶŐŝƐƐƵĞĚ͕ƐƵĐŚĂƐĞůĞĐƚƌŝĐĂů͕ŐĂƐ͕ŵĞĐŚĂŶŝĐĂů͕ƉůƵŵďŝŶŐĞƋƵŝƉŵĞŶƚĂŶĚƉĞƌŵĂŶĞŶƚƐLJƐƚĞŵƐ͘If, in
ƚŚĞŽƉŝŶŝŽŶŽĨƚŚĞďƵŝůĚŝŶŐŽĸĐŝĂů͕ƚŚĞǀĂůƵĂƟŽŶŝƐƵŶĚĞƌĞƐƟŵĂƚĞĚŽŶƚŚĞĂƉƉůŝĐĂƟŽŶ͕ƚŚĞƉĞƌŵŝƚƐŚĂůůďĞ
denied,ƵŶůĞƐƐƚŚĞĂƉƉůŝĐĂŶƚĐĂŶƐŚŽǁĚĞƚĂŝůĞĚĞƐƟŵĂƚĞƐƚŽŵĞĞƚƚŚĞĂƉƉƌŽǀĂůŽĨƚŚĞďƵŝůĚŝŶŐŽĸĐŝĂů͘&ŝŶĂů
ďƵŝůĚŝŶŐƉĞƌŵŝƚǀĂůƵĂƟŽŶƐŚĂůůďĞƐĞƚďLJƚŚĞďƵŝůĚŝŶŐŽĸĐŝĂů͘
ŝƚLJƉŽůŝĐLJŝŶĚŝĐĂƚĞƐƚŚĂƚƉĞƌŵŝƚǀĂůƵĂƟŽŶŝŶĐůƵĚĞƐŵĂƚĞƌŝĂůƐĂŶĚůĂďŽƌĨŽƌƚŚĞƐƚƌƵĐƚƵƌĞĂŶĚŵĞĐŚĂŶŝĐĂů͕
ĞůĞĐƚƌŝĐĂů͕ƉůƵŵďŝŶŐĂŶĚŐĂƐ͕ĮƌĞƐƉƌŝŶŬůĞƌĂŶĚĞůĞǀĂƚŽƌƐLJƐƚĞŵƐĂŶĚĞƋƵŝƉŵĞŶƚ͘WĞƌŵĂŶĞŶƚƐLJƐƚĞŵƐƐƵĐŚĂƐ
ĂƵĚŝŽǀŝƐƵĂů͕ůŝŐŚƟŶŐĂŶĚ,sĐŽŶƚƌŽůƐĂƌĞŝŶĐůƵĚĞĚŝŶƚŚĞƚŽƚĂůĂƐĂƌĞĞdžƉĞŶƐĞƐĚŝƌĞĐƚůLJƌĞůĂƚĞĚƚŽĐŽŶƐƚƌƵĐƟŽŶ
ƐƵĐŚĂƐĞƋƵŝƉŵĞŶƚƌĞŶƚĂůĂŶĚĐŽŶƚƌĂĐƚŽƌĨĞĞƐ͘&ŝŶŝƐŚŵĂƚĞƌŝĂůƐƐƵĐŚĂƐƉĂŝŶƚ͕ŇŽŽƌĐŽǀĞƌŝŶŐƐ͕ƟůĞ͕ĐĂďŝŶĞƚƐĂŶĚ
ĐŽƵŶƚĞƌƚŽƉƐĂƌĞŝŶĐůƵĚĞĚŝŶƚŚĞƉĞƌŵŝƚǀĂůƵĂƟŽŶƚŽƚĂů͘
ŽƐƚƐƐƵĐŚĂƐĂƌĐŚŝƚĞĐƚƵƌĂůĂŶĚĞŶŐŝŶĞĞƌŝŶŐĚĞƐŝŐŶĨĞĞƐ͕ůĂŶĚƐĐĂƉŝŶŐĂŶĚƉůĂŶƟŶŐ͕ƚĂƉĨĞĞƐ͕ĚĞǀĞůŽƉŵĞŶƚ
ŵŝƟŐĂƟŽŶĨĞĞƐ͕ƚƌĂƐŚƌĞŵŽǀĂů͕ĂŶĚĐůĞĂŶŝŶŐĂƌĞŶŽƚŝŶĐůƵĚĞĚ͘
AFFIDAVIT POLICY
/ĐĞƌƟĨLJƚŚĂƚƚŚĞƉĞƌŵŝƚǀĂůƵĂƟŽŶĞŶƚĞƌĞĚŽŶƚŚĞƉĞƌŵŝƚĂƉƉůŝĐĂƟŽŶĨŽƌƚŚŝƐƉƌŽƉĞƌƚLJĐŽŵƉůŝĞƐǁŝƚŚƚŚĞĂďŽǀĞ
ǀĂůƵĂƟŽŶƌĞƋƵŝƌĞŵĞŶƚƐ͘/ƵŶĚĞƌƐƚĂŶĚƚŚĂƚƚŚŝƐĚŽĐƵŵĞŶƚŝƐĂƉƵďůŝĐĚŽĐƵŵĞŶƚ͘
KǁŶĞƌ^ŝŐŶĂƚƵƌĞ͗ ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĂƚĞ͗ͺͺͺͺͺͺͺͺͺͺͺ
KǁŶĞƌWƌŝŶƚĞĚEĂŵĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
Žƌ͕
ƵƚŚŽƌŝnjĞĚŐĞŶƚ^ŝŐŶĂƚƵƌĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĂƚĞ͗ͺͺͺͺͺͺͺͺͺͺͺ
ƵƚŚŽƌŝnjĞĚŐĞŶƚWƌŝŶƚĞĚEĂŵĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ƵŐƵƐƚϮϬϭϳ
01/08/2018
Ğƌƌƌƌƌƌƌƌƌƌƌƌŵŝŵŵŝŵŝŵŵŵŵŝŵŵŵŵŵŵŵŵŵŵŵŵŵŵŵŵŵŵŵŝŵŵŵŵŝŝŝŵƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚ ƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐŚƐƐƐƐŚƐƐƐŚƐƐŚƐƐƐŚƐƐŚŚƐŚŚŚŚŚƐƐŚĂůĂůĂůĂĂůĂĂĂůĂůĂĂůĂůĂĂĂůĂůĂůĂůĂĂůĂĂĂĂĂĂĂůĂůĂĂĂůĂĂĂĂĂůĂĂĂĂĂůĂůĂů ďĞĞĞďĞďĞďĞďĞďĞĞďĞďĞďĞďĞĞĞĞĞďĞďĞďĞďĞďďĞďĞďĞĞĞďĞďĞďĞďďĞďĞĞďĞďĞĞďĞĞĞďĞĞĞĞĞĞĞďĞĞ
ŽĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĸĐŝĐŝĐŝĐŝĐĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐŝĐĐĐŝĐŝĐŝĐŝĐŝĐĐŝĐŝĐŝĐŝĐŝĐĐĐŝĐĐŝĐŝĐŝĐŝŝĐŝĐŝĐŝĐŝŝĐĐĐŝĐŝĐĐĐĐĐĐĐĐĐĐĐĐĐĂůĂůĂůĂůĂůĂůĂůĂĂĂůĂůĂůĂůĂůĂůĂĂůĂůĂůĂůĂůĂĂĂůĂůĂĂĂůůĂĂĂůĂůĂůĂĂĂĂĂĂĂĂůĂĂĂĂĂĂĂĂůĂĂ͘͘͘͘͘͘͘&ŝ&&ŝ&&&&ŝ&&ŝ&ŝ&&&ŝ&ŝ&&ŝ&&&ŝ&&ŝŝ&ŝ&&&ŝ&ŝ&&ŝ&ŝ&ŝ&ŝ&ŝ&ŝ&ŝ&ŝ&&ŝ&ŝ&&ŝŝŝŝŝŝ&ŝŶĂŶĂŶĂŶĂŶĂŶĂŶĂŶĂŶĂĂĂŶĂŶĂŶĂŶĂĂĂŶĂĂŶĂŶĂŶĂŶŶĂŶĂŶĂŶĂŶĂŶĂĂŶĂŶĂŶŶĂĂŶĂŶĂŶĂŶŶĂĂĂŶĂĂĂĂŶĂĂŶĂŶĂŶĂĂůůůůůůůůůůůůůů
ŵĞĐŚĂŶŝĐĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂů͕ůů͕͕ů͕ů͕͕ů͕ů͕ů͕ů͕ů͕ů͕ů͕ů͕ů͕ů͕͕ů͕ů͕͕͕͕͕ů͕ů͕͕͕͕͕͕͕
ƐƚĞŵĞŵĞŵĞŵŵŵĞŵŵĞŵĞŵĞŵĞŵĞŵĞŵŵĞŵŵŵŵŵŵŵĞĞŵĞŵĞŵĞŵŵĞŵĞŵŵŵŵĞŵĞĞŵĞŵĞŵĞŵĞŵŵĞŵŵĞŵĞŵĞŵĞŵŵŵĞŵŵŵĞŵĞŵĞĞŵĞŵĞĞĞĞŵŵŵŵĞĞĞŵĞĞĞĞŵŵŵĞĞĞŵŵŵŵŵĞŵŵĞƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐ ƐƵƐƵƐƵƐƐƐƐƐƵƐƵƐƵƐƵƐƵƐƵƐƵƐƵƐƐƐƐƐƵƵƵƵƐƵƐƵƐƵƐƵƐƵƐƐƐƵƐƵƐƵƐƵƵƐƵƐƵƐƵƐƵƐƐƐƐƐƵƐƵƐƵƐƵƐƵƐƵƐƵƐƵƵƐƵƐƵƐƵƐƐƵƐƵƐƵƵƵƐƵƐƵƐƐƐƐƵƵƐƵƐƵƐƵƐƵƐƐƐƵƐƐƐƐƐƵƵƵƐƵƐƐƵƐƵƵƵƵƵƵƐƵƐƵƵƐƐƵƵĐŚĐŚĐŚĐĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚĐŚŚĐŚĐŚĐŚĐŚĐŚŚŚŚŚŚŚŚĐŚĐŚĐŚĐŚŚŚŚŚĐŚĐŚŚŚŚŚŚĐŚŚĐĐĐĐĐĐŚĐŚĐĐĐĐĐĐŚĐĐĐĐŚĐĐĐĐŚĐĐŚĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐĐ ĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐƐ
ĞĚ ƚŽ ĐŽŶƐƚƌƵĐƟŽŶ
Juan Lagarrigue Digitally signed by Juan
Lagarrigue
Date: 2017.12.16 12:12:37 -07'00'
COMMUNITY DEVELOPMENT DEPARTMENT
ASBESTOS VERIFICATION AND CHECKLIST
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
ƐďĞƐƚŽƐŝƐĂŬŶŽǁŶŚƵŵĂŶĐĂƌĐŝŶŽŐĞŶĂŶĚŝƐĂŶĂŝƌďŽƌŶĞŚĂnjĂƌĚ͘KŶĐĞĂŝƌďŽƌŶĞ͕ĂƐďĞƐƚŽƐĮďĞƌƐĐĂŶƐƚĂLJƐƵƐƉĞŶĚĞĚŝŶƚŚĞĂŝƌĨŽƌĚĂLJƐ͕
ǁĞĞŬƐ͕ŽƌĞǀĞŶŵŽŶƚŚƐďĞĨŽƌĞƐĞƩůŝŶŐŽƵƚŽĨƚŚĞĂŝƌ͘dŚĞĮďĞƌƐĐĂŶĞĂƐŝůLJďĞĐŽŵĞĂŝƌďŽƌŶĞĂŐĂŝŶĨƌŽŵĂŵŝŶŽƌĚŝƐƚƵƌďĂŶĐĞůŝŬĞƚƵƌŶŝŶŐ
ŽŶĂŶĂŝƌĐŽŶĚŝƟŽŶĞƌ͘hŶĐŽŶƚƌŽůůĞĚĂƐďĞƐƚŽƐĂďĂƚĞŵĞŶƚƉƌŽũĞĐƚƐŽƌƌĞŶŽǀĂƟŽŶƉƌŽũĞĐƚƐƚŚĂƚĚŝƐƚƵƌďĂƐďĞƐƚŽƐŵĂLJĐĂƵƐĞůĂƚĞŶƚĂƐďĞƐƚŽƐ
ŚĂnjĂƌĚƐƚŚĂƚĐŽƵůĚĞdžƉŽƐĞƉĞŽƉůĞƚŽĂƐďĞƐƚŽƐŝŶƚŚĞĨƵƚƵƌĞ͕ůŽŶŐĂŌĞƌƚŚĞƌĞŶŽǀĂƟŽŶĂĐƟǀŝƚLJŽĐĐƵƌƌĞĚ͘dŚĞĂŝƌďŽƌŶĞĂƐďĞƐƚŽƐĮďĞƌ
ĐŽŶĐĞŶƚƌĂƟŽŶƐƌĞƐƵůƟŶŐĨƌŽŵĚŝƐƚƵƌďĂŶĐĞƐŵĂLJƌĞƐƵůƚŝŶĂƐŝŐŶŝĮĐĂŶƚĞdžƉŽƐƵƌĞƚŽƚŚĞĐƵƌƌĞŶƚĂŶĚĨƵƚƵƌĞŽĐĐƵƉĂŶƚƐŽĨƚŚĞŚŽŵĞ͘
The 1989 “ban” on asbestos-containing materials is commonly misunderstood./ŶĨĂĐƚ͕ŝŶϭϵϵϭƚŚĞh͘^͘&ŝŌŚŝƌĐƵŝƚŽƵƌƚŽĨĂƉƉĞĂůƐ
ǀĂĐĂƚĞĚŵƵĐŚŽĨƚŚĞƐŽͲĐĂůůĞĚ͞ƐďĞƐƚŽƐĂŶĂŶĚWŚĂƐĞŽƵƚZƵůĞ͟ĂŶĚƌĞŵĂŶĚĞĚŝƚƚŽƚŚĞW͘dŚƵƐ͕ŵƵĐŚŽĨƚŚĞŽƌŝŐŝŶĂůϭϵϴϵWďĂŶ
ŽŶƚŚĞh͘^͘ŵĂŶƵĨĂĐƚƵƌŝŶŐ͕ŝŵƉŽƌƚĂƟŽŶ͕ƉƌŽĐĞƐƐŝŶŐ͕ŽƌĚŝƐƚƌŝďƵƟŽŶŝŶĐŽŵŵĞƌĐĞŽĨŵĂŶLJĂƐďĞƐƚŽƐͲĐŽŶƚĂŝŶŝŶŐƉƌŽĚƵĐƚĐĂƚĞŐŽƌŝĞƐǁĂƐ
ƐĞƚĂƐŝĚĞĂŶĚ/EKdd<&&d͘dŚĞƌĞĨŽƌĞ͕>>ĚĞŵŽůŝƟŽŶ͕ƌĞŵŽĚĞůŽƌƌĞŶŽǀĂƟŽŶƉƌŽũĞĐƚƐŵƵƐƚĚĞƚĞƌŵŝŶĞŝĨĚŝƐƚƵƌďĞĚŵĂƚĞƌŝĂů
ĂďŽǀĞƚŚĞƚƌŝŐŐĞƌůĞǀĞůƐĐŽŶƚĂŝŶƐĂƐďĞƐƚŽƐ͘
ASBESTOS INFORMATION
Yes No
ZĞƐŝĚĞŶƟĂů:tŝůůLJŽƵďĞƌĞŵŽǀŝŶŐŵŽƌĞƚŚĂŶϯϮƐƋŌ͕ϱϬůŝŶĞĂƌĨĞĞƚ;Ğ͘Ő͕͘ƉŝƉĞŝŶƐƵůĂƟŽŶͿ͕ŽƌƚŚĞǀŽůƵŵĞ
ĞƋƵŝǀĂůĞŶƚŽĨĂϱϱͲŐĂůůŽŶĚƌƵŵŽĨĂŶLJŵĂƚĞƌŝĂůďĞƐŝĚĞƐĐŽŶĐƌĞƚĞ͕ǁŽŽĚ͕ďƌŝĐŬƐ͕ŽƌƐƚĞĞůʹĞdžĂŵƉůĞƐĂƌĞĚƌLJǁĂůů͕
ůŝŶŽůĞƵŵ͕ĐĞŝůŝŶŐƟůĞƐ͕ƌŽŽĮŶŐŵĂƚĞƌŝĂůƐ͕ĞƚĐ͍͘
Yes No
Commercial:tŝůůLJŽƵďĞƌĞŵŽǀŝŶŐŵŽƌĞƚŚĂŶϭϲϬƐƋŌ͕ϮϲϬůŝŶĞĂƌĨĞĞƚ;Ğ͘Ő͕͘ƉŝƉĞŝŶƐƵůĂƟŽŶͿ͕ŽƌƚŚĞǀŽůƵŵĞ
ĞƋƵŝǀĂůĞŶƚŽĨĂϱϱͲŐĂůůŽŶĚƌƵŵŽĨĂŶLJŵĂƚĞƌŝĂůďĞƐŝĚĞƐĐŽŶĐƌĞƚĞ͕ǁŽŽĚ͕ďƌŝĐŬƐ͕ŽƌƐƚĞĞůʹĞdžĂŵƉůĞƐĂƌĞĚƌLJǁĂůů͕
ůŝŶŽůĞƵŵ͕ĐĂƌƉĞƚ͕ĐĂƌƉĞƚĂĚŚĞƐŝǀĞƐ͕ĐĞŝůŝŶŐƟůĞƐ͕ƌŽŽĮŶŐŵĂƚĞƌŝĂůƐ͕ĞƚĐ͍͘
If the answer is YES to any of the above, you will need an asbestos test before you can receive a building and/
ŽƌĚĞŵŽůŝƟŽŶƉĞƌŵŝƚ͘zŽƵǁŝůůĂůƐŽŶĞĞĚƚŽƉƌŽǀŝĚĞƉůĂŶƐŝŶĚŝĐĂƟŶŐĂƌĞĂƐƚŽďĞĚĞŵŽůŝƐŚĞĚĂŶĚĚĞƚĞƌŵŝŶĞŝĨĂ
KƐƚĂƚĞĚĞŵŽůŝƟŽŶůŝĐĞŶƐĞŝƐƌĞƋƵŝƌĞĚ͘ƐƚĂƚĞĐĞƌƟĮĞĚĂƐďĞƐƚŽƐŝŶƐƉĞĐƚŽƌŵƵƐƚĚŽƚŚŝƐƚĞƐƚĂŶĚƚŚĞƚĞƐƚƌĞƉŽƌƚ
ŵƵƐƚďĞƐƵďŵŝƩĞĚǁŝƚŚƚŚĞďƵŝůĚŝŶŐƉĞƌŵŝƚĂƉƉůŝĐĂƟŽŶ͘/ĨƚŚĞďƵŝůĚŝŶŐŚĂƐĂƐďĞƐƚŽƐ͕ĂƐƚĂƚĞĐĞƌƟĮĞĚĂƐďĞƐƚŽƐ
ĂďĂƚĞŵĞŶƚĮƌŵŵƵƐƚƌĞŵŽǀĞŝƚ͘ŌĞƌƌĞŵŽǀĂů͕ƚŚĞĂďĂƚĞŵĞŶƚĮƌŵŵƵƐƚƉƌŽǀŝĚĞĂůĞƩĞƌƚŽƚŚĞƵŝůĚŝŶŐŝǀŝƐŝŽŶ
ƐƚĂƟŶŐƚŚĂƚĂůůƚŚĞĂƐďĞƐƚŽƐŚĂƐďĞĞŶƌĞŵŽǀĞĚĂŶĚƚŚĂƚƚŚĞĂŝƌŝƐĐůĞĂŶ͘dŚŝƐůĞƩĞƌŵƵƐƚďĞƌĞĐĞŝǀĞĚ&KZĂ
ƉĞƌŵŝƚǁŝůůďĞŝƐƐƵĞĚ͘;^ĞĞƚŚĞůŽĐĂůŽƌƐƚĂƚĞǁŝĚĞzĞůůŽǁWĂŐĞƐ͕ĞdžKŶ>ŝŶĞ͕ŽƌŚƩƉ͗ͬͬǁǁǁ͘ĐĚƉŚĞ͘ƐƚĂƚĞ͘ĐŽ͘ƵƐͬĂƉͬ
ĂƐďĞƐƚŽƐͬŝŶĚĞdž͘ŚƚŵůĨŽƌĐĞƌƟĮĞĚĂƐďĞƐƚŽƐŝŶƐƉĞĐƚŽƌƐĂŶĚĂďĂƚĞŵĞŶƚĐŽŵƉĂŶŝĞƐ͘>tz^ĂƐŬĨŽƌƉƌŽŽĨŽĨĐƵƌƌĞŶƚ
ƐƚĂƚĞĐĞƌƟĮĐĂƟŽŶ͘Ϳ
If you are demolishing the building͕LJŽƵŵƵƐƚƐƵďŵŝƚĂĚĞŵŽůŝƟŽŶƉĞƌŵŝƚĂƉƉǁŝƚŚƚŚĞW,ŝŶĂĚĚŝƟŽŶƚŽƚŚĞ
ƐƉĞŶƉĞƌŵŝƚĂƉƉ͘dŚŝƐĨŽƌŵŵĂLJďĞĨŽƵŶĚĂƚŚƩƉƐ͗ͬͬǁǁǁ͘ĐŽůŽƌĂĚŽ͘ŐŽǀͬƉĂĐŝĮĐͬĐĚƉŚĞͬĂƐďĞƐƚŽƐͲĨŽƌŵƐ EKd͗
ĐŽƉLJŽĨƚŚŝƐĚĞŵŽůŝƟŽŶƉĞƌŵŝƚĂƉƉŵƵƐƚďĞƐƵďŵŝƩĞĚǁŝƚŚƚŚĞŝŶŝƟĂůďƵŝůĚŝŶŐƉĞƌŵŝƚĂƉƉůŝĐĂƟŽŶ͘tŚĞŶƚŚĞ
W,ĂƉƉƌŽǀĞƐƚŚĞĂƉƉ͕ƚŚĞŝƌŝƐƐƵĞĚƉĞƌŵŝƚŵƵƐƚďĞŐŝǀĞŶƚŽƚŚĞƐƉĞŶƵŝůĚŝŶŐĞƉƚďĞĨŽƌĞǁĞŝƐƐƵĞŽƵƌ
ƉĞƌŵŝƚ͘
ASBESTOS CHECKLIST
/ŚĞƌĞďLJĐĞƌƟĨLJƚŚĂƚƚŚĞĂďŽǀĞŝŶĨŽƌŵĂƟŽŶŝƐƚƌƵĞĂŶĚĐŽŵƉůĞƚĞ͘
Owner______________________________ Phone #___________________________
ƉƉůŝĐĂŶƚ;ƉƌŝŶƚŶĂŵĞͿͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWŚŽŶĞηͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ƉƉůŝĐĂŶƚ^ŝŐŶĂƚƵƌĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺĂƚĞͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
WůĞĂƐĞĐĂůůƚŚĞŝƚLJŽĨƐƉĞŶŶǀŝƌŽŶŵĞŶƚĂů,ĞĂůƚŚĞƉĂƌƚŵĞŶƚĂƚϵϮϬͲϱϬϯϵĂƚĂŶLJƟŵĞŝĨLJŽƵŚĂǀĞƋƵĞƐƟŽŶƐ
ĂďŽƵƚĂƐďĞƐƚŽƐ͕ŝŶƚĞƌƉƌĞƟŶŐLJŽƵƌƚĞƐƚƌĞƐƵůƚƐ͕ŽƌŽƚŚĞƌŵĂƩĞƌƐ͘
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
August 2017
01/08/2018
Žƌ ƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚŚĞŚĞŚŚŚĞŚĞŚĞŚĞŚĞŚŚĞŚĞŚĞŚĞŚĞĞŚĞĞŚĞŚŚĞĞŚĞŚĞŚĞĞĞŚŚŚŚŚĞĞĞĞŚĞŚĞĞŚŚĞŚĞ ǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀǀŽůŽůŽůŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽůŽŽŽŽŽŽŽůŽŽŽŽůŽůŽŽŽŽŽŽůŽŽŽŽŽŽŽŽŽŽŽŽŽŽŽƵŵƵŵƵŵƵŵƵŵƵŵƵŵŵŵƵŵŵŵŵŵŵƵŵƵŵƵŵŵŵŵŵƵŵƵŵŵŵƵŵŵŵŵŵŵŵƵŵŵŵŵŵƵŵƵŵƵŵƵŵŵƵŵƵƵƵƵĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞ
ƉůĞƐĞĞĞĞƐĞĞƐĞĞĞƐĞƐĞƐĞƐĞƐĞĞĞĞĞĞĞĞĞƐĞĞĞĞĞĞĞĞĞ ĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂĂƌĞƌĞƌĞƌĞĞƌĞĞĞƌĞƌĞƌĞƌĞƌĞƌĞĞĞĞĞĞĞƌĞƌƌĞƌĞĞƌĞĞĞ ĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚĚƌLJƌLJƌLJƌLJLJLJLJLJLJƌLJLJLJLJLJLJLJLJLJLJLJLJǁĂǁĂǁǁǁǁǁĂǁĂǁĂǁĂǁĂǁĂǁĂǁĂǁĂĂĂĂĂǁĂǁǁǁǁǁĂǁǁǁĂǁǁůůůůůůůůůůůů͕
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ĂŶĚ ƚŚĞ ƚĞƐƚ ƌĞƉŽƌƚ
Ian Metcalf 970.319.9525
Juan Lagarrigue
970.9987.3216
Juan Lagarrigue Digitally signed by Juan
Lagarrigue
Date: 2017.12.16 12:13:48 -07'00'2017.12.16
COMMUNITY DEVELOPMENT DEPARTMENT
ZONING COMPLIANCE VERIFICATION POLICY
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
Applicability: ůůĚĞǀĞůŽƉŵĞŶƚƉƌŽũĞĐƚƐŵƵƐƚĐŽŵƉůLJǁŝƚŚƚŚĞŝƚLJ͛ƐnjŽŶŝŶŐƌĞŐƵůĂƟŽŶƐ͕ŝŶĐůƵĚŝŶŐŚĞŝŐŚƚĂŶĚ
ůŽĐĂƟŽŶ͕ĂŶĚĂƌĞƐƵďũĞĐƚƚŽƉĞƌŝŽĚŝĐŝŶƐƉĞĐƟŽŶĚƵƌŝŶŐĐŽŶƐƚƌƵĐƟŽŶĂŶĚĂĮŶĂůŝŶƐƉĞĐƟŽŶƉƌŝŽƌƚŽƉƌŽũĞĐƚ
ĐŽŵƉůĞƟŽŶ͘tŚĞŶƌĞƋƵŝƌĞĚďLJƚŚĞŝƚLJ͛ƐŽŶŝŶŐKĸĐĞƌ͕ĐĞƌƚĂŝŶĚĞǀĞůŽƉŵĞŶƚƉƌŽũĞĐƚƐǁŝƚŚŝŶƚŚĞŝƚLJŽĨƐƉĞŶ
ƐŚĂůůǀĞƌŝĨLJŚĞŝŐŚƚĂŶĚͬŽƌůŽĐĂƟŽŶĐŽŵƉůŝĂŶĐĞƚŚƌŽƵŐŚƐƵďŵŝƐƐŝŽŶŽĨĂƐƵƌǀĞLJƌĞƉŽƌƚ͘
hŶůĞƐƐŽƚŚĞƌǁŝƐĞĞdžĞŵƉƚĞĚ͕ĂůůĐŽŵŵĞƌĐŝĂů͕ŵƵůƟͲĨĂŵŝůLJ͕ůŽĚŐŝŶŐ͕ĂŶĚŵŝdžĞĚͲƵƐĞƉƌŽũĞĐƚƐƉƌŽƉŽƐĞĚǁŝƚŚŝŶŽŶĞ
ĨŽŽƚŽĨƚŚĞŵĂdžŝŵƵŵƉĞƌŵŝƐƐŝďůĞŚĞŝŐŚƚŽƌǁŝƚŚŝŶŽŶĞĨŽŽƚŽĨĂůůŽǁĂďůĞƐĞƚďĂĐŬƐƐŚĂůůǀĞƌŝĨLJnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞ
through this method.
/ŶĂĚĚŝƟŽŶ͕ƚŚĞŽŶŝŶŐKĸĐĞƌŵĂLJƌĞƋƵŝƌĞƚŚŝƐŵĞƚŚŽĚďĞƵƐĞĚƚŽǀĞƌŝĨLJnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞĨŽƌƐŝŶŐůĞͲĨĂŵŝůLJͬ
ĚƵƉůĞdžĚĞǀĞůŽƉŵĞŶƚŽƌŽƚŚĞƌƉƌŽũĞĐƚƐǁŚĞƌĞĐŽŵƉůŝĂŶĐĞŵĂLJďĞŝŶƋƵĞƐƟŽŶ͘/ŶĚĞƉĞŶĚĞŶƚŽĨƚŚŝƐƉŽůŝĐLJ͕Ăůů
ƉƌŽũĞĐƚƐŵƵƐƚĐŽŵƉůLJǁŝƚŚĂůůĂƉƉůŝĐĂďůĞnjŽŶŝŶŐůŝŵŝƚĂƟŽŶƐ͘
dŚĞŽŶŝŶŐKĸĐĞƌǁŝůůŝŶĨŽƌŵƚŚĞĂƉƉůŝĐĂŶƚĚƵƌŝŶŐďƵŝůĚŝŶŐƉĞƌŵŝƚƌĞǀŝĞǁŝĨǀĞƌŝĮĐĂƟŽŶǁŝůůďĞƌĞƋƵŝƌĞĚ͘
,ŽǁĞǀĞƌ͕ĐŝƌĐƵŵƐƚĂŶĐĞƐŵĂLJƌĞƋƵŝƌĞnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞǀĞƌŝĮĐĂƟŽŶŽĨĂƉƌŽũĞĐƚǁŚŝĐŚŝƐĂůƌĞĂĚLJƵŶĚĞƌǁĂLJ͘
Timing: ,ĞŝŐŚƚǀĞƌŝĮĐĂƟŽŶƐŚŽƵůĚďĞĂĐĐŽŵƉůŝƐŚĞĚĂƚĂƉŽŝŶƚŽĨĐŽŶƐƚƌƵĐƟŽŶǁŚĞŶĞŶŽƵŐŚƌŽŽĨƐƚƌƵĐƚƵƌĞŝƐŝŶ
ƉůĂĐĞƚŽĂĐĐƵƌĂƚĞůLJŵĞĂƐƵƌĞƚŚĞƐƚƌƵĐƚƵƌĞLJĞƚĞĂƌůLJĞŶŽƵŐŚŝŶƚŚĞƉƌŽĐĞƐƐƚŽƐƟůůŵĂŬĞĐŚĂŶŐĞƐŝĨƚŚĞƐƚƌƵĐƚƵƌĞ
ŝƐƚŽŽƚĂůů͘>ŽĐĂƟŽŶǀĞƌŝĮĐĂƟŽŶƐŚŽƵůĚďĞĂĐĐŽŵƉůŝƐŚĞĚĂƚĂƉŽŝŶƚŽĨĐŽŶƐƚƌƵĐƟŽŶǁŚĞŶƚŚĞĮŶĂůĞdžƚĞƌŝŽƌŽĨƚŚĞ
ƐƚƌƵĐƚƵƌĞĐĂŶďĞĂĐĐƵƌĂƚĞůLJŵĞĂƐƵƌĞĚŝŶƌĞůĂƟŽŶƚŽƐĞƚďĂĐŬƌĞƋƵŝƌĞŵĞŶƚƐ͘ƉƉůŝĐĂŶƚƐĂƌĞĞŶĐŽƵƌĂŐĞĚƚŽĐŽŶĨĞƌ
ǁŝƚŚƚŚĞŽŶŝŶŐKĸĐĞƌƌĞŐĂƌĚŝŶŐƚŚĞƟŵŝŶŐŽĨnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞǀĞƌŝĮĐĂƟŽŶ͘ƉƉůŝĐĂŶƚƐĂƌĞĞŶĐŽƵƌĂŐĞĚƚŽ
ƉĞƌĨŽƌŵƚŚĞŝƌŽǁŶǀĞƌŝĮĐĂƟŽŶĚƵƌŝŶŐĐŽŶƐƚƌƵĐƟŽŶƚŽĞŶƐƵƌĞƚŚĞďƵŝůĚŝŶŐŝƐƉƌŽŐƌĞƐƐŝŶŐƚŽƉůĂŶ͕ŝŶĐůƵĚŝŶŐƚŚĞ
ŚĞŝŐŚƚĂŶĚůŽĐĂƟŽŶŽĨĨŽƵŶĚĂƟŽŶĨŽƌŵƐƉƌŝŽƌƚŽĐŽŶĐƌĞƚĞƉŽƵƌƐ͘
Survey Report:ŽůŽƌĂĚŽWƌŽĨĞƐƐŝŽŶĂů>ĂŶĚ^ƵƌǀĞLJŽƌƐŚĂůůĚĞƐĐƌŝďĞĂŶĚĚĞƉŝĐƚƚŚĞŚĞŝŐŚƚĂŶĚůŽĐĂƟŽŶŽĨĂ
ƐƚƌƵĐƚƵƌĞĐŽŵƉĂƌĞĚƚŽƚŚĞĚŝŵĞŶƐŝŽŶƐƐŚŽǁŶŽŶƚŚĞnjŽŶŝŶŐƐŚĞĞƚƐŽĨƚŚĞĂƉƉƌŽǀĞĚďƵŝůĚŝŶŐƉĞƌŵŝƚƉůĂŶƐĞƚ͘dŚĞ
ŝƚLJ͛ƐŽŶŝŶŐKĸĐĞƌĐĂŶĂƐƐŝƐƚŝŶĚĞƚĞƌŵŝŶŝŶŐǁŚŝĐŚĞůĞŵĞŶƚƐŽĨƚŚĞƐƚƌƵĐƚƵƌĞƐŚŽƵůĚďĞŵĞĂƐƵƌĞĚĂŶĚŝĨŶĂƚƵƌĂů
ŽƌĮŶŝƐŚĞĚŐƌĂĚĞƐŚŽƵůĚďĞƵƐĞĚ͘
dŚĞƌĞƉŽƌƚƐŚĂůůŝŶĐůƵĚĞƚŚĞĨŽůůŽǁŝŶŐŝŶĨŽƌŵĂƟŽŶ͗
ϭͲďƌŝĞĨĐŽǀĞƌůĞƩĞƌǁŝƚŚƚŚĞďƵŝůĚŝŶŐƉĞƌŵŝƚŶƵŵďĞƌ͕ŶĂŵĞŽĨƚŚĞƉƌŽũĞĐƚ͕ŶĂŵĞŽĨƚŚĞŽǁŶĞƌĂŶĚŐĞŶĞƌĂů
ĐŽŶƚƌĂĐƚŽƌ͕ǁŝƚŚĂǁƌŝƩĞŶĚĞƐĐƌŝƉƟŽŶŽĨƚŚĞŵĞĂƐƵƌĞŵĞŶƚŵĞƚŚŽĚƐŝŶĐůƵĚŝŶŐĚĂƚĞ;ƐͿŽĨŵĞĂƐƵƌĞŵĞŶƚ͘
ϮͲ&ŽƌůŽĐĂƟŽŶǀĞƌŝĮĐĂƟŽŶ͗ƉůĂŶĚƌĂǁŝŶŐƐŚŽǁŝŶŐƉƌŽƉĞƌƚLJďŽƵŶĚĂƌŝĞƐ͕ƉĞƌŵŝƩĞĚƐĞƚďĂĐŬƐ͕ďƵŝůĚŝŶŐĞŶǀĞůŽƉĞ
;ŝĨĂƉƉůŝĐĂďůĞͿ͕ůŽĐĂƟŽŶŽĨĨŽƵŶĚĂƟŽŶǁĂůůƐ͕ůŽĐĂƟŽŶŽĨƚŚĞŽƵƚĞƌŵŽƐƚĞdžƚĞƌŝŽƌŽĨĞĂĐŚƐƚƌƵĐƚƵƌĞ;ŝŶĐůƵƐŝǀĞŽĨĂůů
ĞdžƚĞƌŝŽƌǀĞŶĞĞƌŽƌŽƚŚĞƌĞdžƚĞƌŝŽƌƚƌĞĂƚŵĞŶƚƐͿ͕ĂŶĚƚŚĞůŽĐĂƟŽŶĂŶĚĚŝŵĞŶƐŝŽŶŽĨĞĂĐŚŽďƐĞƌǀĞĚŵĞĂƐƵƌĞŵĞŶƚ͘
ϯͲ&ŽƌŚĞŝŐŚƚǀĞƌŝĮĐĂƟŽŶ͗ůĞǀĂƟŽŶĚƌĂǁŝŶŐ;ƐͿƐŚŽǁŝŶŐƚŚĞŶĂƚƵƌĂůŽƌĮŶŝƐŚĞĚŐƌĂĚĞŽĨƚŚĞƉƌŽƉĞƌƚLJ͕ŵĂdžŝŵƵŵ
ƉĞƌŵŝƩĞĚŚĞŝŐŚƚ͕ďƵŝůĚŝŶŐĞůĞǀĂƟŽŶƐŝŶĐůƵĚŝŶŐƚŚĞŶŽŵŝŶĂůƌŽŽĨĨŽƌŵ;ŝŶĐůƵƐŝǀĞŽĨƚŚĞĮƌƐƚůĂLJĞƌŽĨĞdžƚĞƌŝŽƌ
ƐŚĞĂƚŚŝŶŐŽƌǁĞĂƚŚĞƌƉƌŽŽĮŶŐŵĞŵďƌĂŶĞďƵƚĞdžĐůƵĚŝŶŐĂůůĞdžƚĞƌŝŽƌƐƵƌĨĂĐĞƚƌĞĂƚŵĞŶƚƐƐƵĐŚĂƐƐŚĂŬĞƐ͕ƐŚŝŶŐůĞƐ͕
ŽƌŽƚŚĞƌǀĞŶĞĞƌƚƌĞĂƚŵĞŶƚƐŽƌŽƌŶĂŵĞŶƚĂƟŽŶͿ͕ĂŶĚƚŚĞůŽĐĂƟŽŶĂŶĚĚŝŵĞŶƐŝŽŶŽĨĞĂĐŚŽďƐĞƌǀĞĚŵĞĂƐƵƌĞŵĞŶƚ͘
ĚĚŝƟŽŶĂůƌŽŽĨƉůĂŶƐƐŚŽǁŝŶŐůŽĐĂƟŽŶŽĨŵĞĂƐƵƌĞŵĞŶƚƐŵĂLJďĞŶĞĐĞƐƐĂƌLJ͘
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
August 2017
01/08/2018
ŽĨƐƚƌƵĐƚƵƌĞŝƐ ŝŶ
ƐŝĨĨĨĨĨĨĨĨĨĨĨĨĨĨ ƚŚƚŚƚŚƚŚƚŚŚƚŚƚŚƚŚƚŚƚŚƚƚŚƚŚŚƚƚĞĞĞĞĞĞĞĞĞĞĞĞĞĞĞ ƐƚƐƚƐƚƐƚƐƚƐƚƐƚƐƚƐƚƐƚƐƚƚƚƚƚƌƵƌƵƌƵƌƵƌƵƌƵƌƵƵƌƵƵƵƵƌƵĐƚĐƚĐƚĐƚĐƚĐƚĐƚĐĐƚƚĐƚĐƵƌƵƌƵƌƵƌƵƌƵƌƵƌƵƌƌƵƌƌƵƌĞĞĞĞĞĞĞĞĞĞĞĞĞ
Ăů ĞĞĞĞĞdžƚdžƚdžƚƚƚƚƚƚdžƚƚƚƚƚƚƚƚĞƌĞƌĞƌĞƌĞƌƌŝŽŽŽŽŽŽŽŽŽƌƌ ĨĨĨĨĨĨĨŽĨ ƚƚƚƚƚƚƚƚƚƚƚŚĞŚŚ
Ő
Ŷ͕ŝŶĐĐĐůƵƵĚŝĚŶŐŶŐŶŐŶŐŶŐŶŐŶŐŶŐŶŐŶŶŐŶŐŶŐŶŐŶŐŐŶŐŶŐŶŐŐŐŐŐ ƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚƚŚĞŚĞŚĞŚĞŚĞŚŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚĞŚŚĞĞĞ
COMMUNITY DEVELOPMENT DEPARTMENT
ZONING COMPLIANCE VERIFICATION POLICY
CITY OF ASPEN 130 S. GALENA ST | ASPEN, CO 81611
ϰͲWůĂŶƐĂŶĚĞůĞǀĂƟŽŶƐŵƵƐƚŝŶĐůƵĚĞŚĞŝŐŚƚŽƌƐĞƚďĂĐŬĞdžĞŵƉƟŽŶŝƚĞŵƐƵŶŝƋƵĞƚŽƚŚĞďƵŝůĚŝŶŐ͕ƐƵĐŚĂƐƐƚĂŝƌͬ
ĞůĞǀĂƚŽƌŽǀĞƌƌƵŶƐ͕ƵƟůŝƚLJͬŵĞĐŚĂŶŝĐĂůĂƉƉĂƌĂƚƵƐ͕ŚŽƚƚƵďƐĂŶĚƐƉĂƐ͕ĂŶĚŽƚŚĞƌŚĞŝŐŚƚŽƌƐĞƚďĂĐŬĞdžĞŵƉƟŽŶŝƚĞŵƐ
ƵŶŝƋƵĞƚŽƚŚĞƉƌŽũĞĐƚ͘
ϱͲdŚĞƌĞƉŽƌƚƐŚĂůůŝŶĐůƵĚĞĂǁƌŝƩĞŶĚĞƐĐƌŝƉƟŽŶŽƌĚƌĂǁŝŶŐŶŽƚĞƐŽĨƚŚĞďĞŶĐŚŵĂƌŬƐŽƌĐŽŶƚƌŽůƉŽŝŶƚƐƵƐĞĚƚŽ
ĞƐƚĂďůŝƐŚƉƌŽƉĞƌƚLJďŽƵŶĚĂƌŝĞƐ͕ƐĞƚďĂĐŬƐ͕ďƵŝůĚŝŶŐůŽĐĂƟŽŶ͕ďƵŝůĚŝŶŐŚĞŝŐŚƚ͕ĂŶĚŐƌĂĚĞƐĨŽƌĞĂĐŚŵĞĂƐƵƌĞŵĞŶƚ͘
ϲͲůůĚƌĂǁŝŶŐƐŵƵƐƚĐŽƌƌĞůĂƚĞǁŝƚŚƚŚĞďƵŝůĚŝŶŐůŽĐĂƟŽŶƐ͕ĞůĞǀĂƟŽŶƐ͕ĂŶĚŐƌĂĚŝŶŐͬĚƌĂŝŶĂŐĞƌĞƉƌĞƐĞŶƚĂƟŽŶƐŝŶ
ƚŚĞĂƉƉƌŽǀĞĚďƵŝůĚŝŶŐƉĞƌŵŝƚƐĞƚ͘
ϳͲdŚĞƌĞƉŽƌƚŵƵƐƚŝŶĐůƵĚĞƚŚĞƐŝŐŶĂƚƵƌĞ͕ĚĂƚĞ͕ĂŶĚƐƚĂŵƉŽĨŽůŽƌĂĚŽWƌŽĨĞƐƐŝŽŶĂů>ĂŶĚ^ƵƌǀĞLJŽƌǁŚŽ
ĐŽŶĚƵĐƚĞĚƚŚĞĮĞůĚŵĞĂƐƵƌĞŵĞŶƚƐĐĞƌƟĨLJŝŶŐƚŚĂƚƚŚĞĮĞůĚŵĞĂƐƵƌĞŵĞŶƚƐĂƌĞĂĐĐƵƌĂƚĞůLJƌĞƉƌĞƐĞŶƚĞĚ͘
Review and Acceptance of Report:dŚĞŽŶŝŶŐKĸĐĞƌƐŚĂůůƌĞǀŝĞǁƚŚĞƌĞƉŽƌƚ;ƐͿĂŶĚĞŝƚŚĞƌĐŽŶĮƌŵƚŚĞƉƌŽũĞĐƚ
ĐŽŶĨŽƌŵƐƚŽƚŚĞĚŝŵĞŶƐŝŽŶƐƐŚŽǁŶŽŶƚŚĞnjŽŶŝŶŐƐŚĞĞƚƐŽĨƚŚĞĂƉƉƌŽǀĞĚďƵŝůĚŝŶŐƉĞƌŵŝƚƉůĂŶƐĞƚĂŶĚŵĞĞƚƐ
ƚŚĞnjŽŶŝŶŐůŝŵŝƚĂƟŽŶƐĨŽƌƚŚĞƉƌŽƉĞƌƚLJŽƌƐŚĂůůĚĞƚĞƌŵŝŶĞǁŚŝĐŚĞůĞŵĞŶƚƐŽĨƚŚĞƉƌŽũĞĐƚĂƌĞŶŽƚŝŶĐŽŵƉůŝĂŶĐĞ͘
dŚĞŽŶŝŶŐKĸĐĞƌŵĂLJƌĞƋƵĞƐƚĂĚĚŝƟŽŶĂůŝŶĨŽƌŵĂƟŽŶƚŽǀĞƌŝĨLJnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞ͕ǁŚŝĐŚŵĂLJŝŶĐůƵĚĞďƵƚŝƐŶŽƚ
ůŝŵŝƚĞĚƚŽĂĚĚŝƟŽŶĂůƐƵƌǀĞLJǁŽƌŬŽƌĂƐŝƚĞǀŝƐŝƚ͘
ůůĚƌĂǁŝŶŐƐŽĨƚŚĞƐƵƌǀĞLJƌĞƉŽƌƚŵƵƐƚĐŽƌƌĞůĂƚĞǁŝƚŚƌĞƉƌĞƐĞŶƚĂƟŽŶƐŝŶƚŚĞĂƉƉƌŽǀĞĚďƵŝůĚŝŶŐƉĞƌŵŝƚƐĞƚĨŽƌ
ĂĐĐĞƉƚĂŶĐĞ͘DŽĚŝĮĐĂƟŽŶƐƚŽĮĞůĚĐŽŶĚŝƟŽŶƐŽƌĂŵĞŶĚŵĞŶƚƐƚŽƚŚĞďƵŝůĚŝŶŐƉĞƌŵŝƚŵĂLJďĞƌĞƋƵŝƌĞĚ͘
ĚĞƚĞƌŵŝŶĂƟŽŶŽĨŶŽŶͲĐŽŵƉůŝĂŶĐĞƐŚĂůůƌĞƐƵůƚŝŶƚŚĞŝƐƐƵĂŶĐĞŽĨĂĐŽƌƌĞĐƟŽŶŶŽƟĐĞĂŶĚƉŽƐƐŝďůĞǁŽƌŬ
ƐƚŽƉƉĂŐĞ͘ƉƉůŝĐĂŶƚƐĂƌĞĞŶĐŽƵƌĂŐĞĚƚŽǀĞƌŝĨLJnjŽŶŝŶŐĐŽŵƉůŝĂŶĐĞĂƐĞĂƌůLJĂƐƌĞĂƐŽŶĂďůLJƉƌĂĐƟĐĂůŝŶƚŚĞ
ĐŽŶƐƚƌƵĐƟŽŶƉƌŽĐĞƐƐƚŽŵŝŶŝŵŝnjĞĚŝƐƌƵƉƟŽŶƚŽƚŚĞĐŽŶƐƚƌƵĐƟŽŶƐĐŚĞĚƵůĞ͘
Acknowledgment:
/;ĐŽŶƚƌĂĐƚŽƌŶĂŵĞͿͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺƵŶĚĞƌƐƚĂŶĚƚŚŝƐƉŽůŝĐLJ͘/ĂŐƌĞĞƚŚĂƚƚŚŝƐƉƌŽũĞĐƚǁŝůů
ĐŽŵƉůLJǁŝƚŚƚŚĞnjŽŶŝŶŐůŝŵŝƚĂƟŽŶƐĂīĞĐƟŶŐƚŚŝƐƉĂƌĐĞůĂŶĚƚŚĞƌĞƉƌĞƐĞŶƚĂƟŽŶƐŵĂĚĞŽŶƚŚĞnjŽŶŝŶŐƐŚĞĞƚƐŽĨ
ƚŚĞĂƉƉƌŽǀĞĚďƵŝůĚŝŶŐƉĞƌŵŝƚƉůĂŶƐ͘/ƵŶĚĞƌƐƚĂŶĚƚŚĂƚĂĞƌƟĮĐĂƚĞŽĨKĐĐƵƉĂŶĐLJǁŝůůŶŽƚďĞŝƐƐƵĞĚƵŶƟůƚŚŝƐ
ƉƌŽũĞĐƚĐŽŵƉůŝĞƐǁŝƚŚĂůůĂƉƉůŝĐĂďůĞnjŽŶŝŶŐůŝŵŝƚĂƟŽŶƐ͘
ŽŶƚƌĂĐƚŽƌ^ŝŐŶĂƚƵƌĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
ĂƚĞ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
Z^^͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺWZD/dEhDZ͗ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ
August 2017
01/08/2018
ŝŶĐůƵĚĞ ďƵƚ ŝƐŶŽƚ
Ƌ
ďůĞĞĞĞĞĞĞĞ ǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽǁŽŽǁǁŽǁŽǁŽǁǁŽƌŬƌŬƌŬƌŬƌŬƌŬƌŬƌŬŬŬƌŬƌŬƌŬƌŬƌŬƌŬƌŬƌŬŬ