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HomeMy WebLinkAboutALL DOCS - 08-00173 - BYUI Chiller Building - Blasting04/10/2008 13:24 m so.0 0 208- 535 -1079 0 CITY OF f �_EXB l..l AMLKICA5 FAMILY COMMUNrIN EAGLE ROCK BLASTING "OPERATIONAL PERMIT" APPLICATION PERMIT #:. PAGE 01 $50.00 FEE PAI :YES /NO PERMIT AP /NO BY' Owner Information Parcel Number: Owner: 8� �la�,� ��M� �� �ka�zal J Phone Number: Lp ' 0709 j U ��"� W t ^^o) e " !& QI+ L `"ke Cry � i Ll7 Z'f1 Owner Mailing Address: - Property Address: V 11va Cell /Office Number: — Business Name Where Work Will Be Done: AVU I��at 10 / Office Address Office Phone Number: N Contact Person: Contact Phone #: Name of Business: t a if. ci 6F Address: E, 5 � _1 F — 0 73461 // Contact Person: ca PHONE NUMBER: 5a CELL # Parade Route /Assembly Location: (Map required for Parades) TO APPLICANTS SIGNATURE DATE �rr���rrrr�rr��r��rrrr�rrrrr�rr���rrr�rrr�rrrrr�rrrrrr 1 19 E. Main St. Phone: 208 - 359 -3020 x322 Rexburg, Idaho 83440 Fax: 208 -359 -3024 www rexburg.org cdd @rexburg.org I 04/10/2008 13:24 Permit #. PLEASE CHECKTHE TYPE OF PERMITS YOU ARE ❑ Aerosol product manufacturing List of contents: ❑ Combustible dust - producing operations Location: Type of dust: ❑ Covered mail buildings Location: ❑ Cryogenic fluids Types: ❑ Cutting and welding operations Location: ❑ Dry Cleaning plants Location: Types of Chemicals: ❑ Exhibits and trade shows Location: Type of Fire Extinguishers & Location: y( Explosives Location: IRW - -� Types: CoM +,oLc T,'dr' CX_P ❑ Fire hydrants and valves Locations: Types: ❑ Flammable and combustible liquids Types: Floor finishing T es: ❑ Fruit and crop ripening Locations: T pes: ❑ Fumigation and thermal insecticidal fogging Locations: Types: 208 - 535 -1079 0 EAGLE ROCK BLASTING 0 APPLYING FOR: ❑ Hazardous materials Locations Types: ❑ High -piled storage Location: Contents: ❑ Hot work operations Location: Dates & Times of Operation: PAGE 02 ❑ HPM facilities Location: ❑ Industrial ovens Location: Types: ❑ Large capacity battery systems Location: Type: ❑ Liquidlgas vehicles /equip. in assembly buildings Location: ❑ LP gas transportation Location: Type: ❑ Lumber yards /plants Location: ❑ Magnesium work Location: ❑ Misc. combustible storage Location: Type: ❑ Open burning Location: Time & Date: ❑ Open flames /torches Location: Time & Date: ❑ Operating amusement buildings Location: 2 04/10/2008 13:24 208 - 535 -1079 EAGLE ROCK BLASTING PAGE 03 Operating aviation facilities Location: ❑ Operating carnivals or fairs Location: Dates & Times: ❑ Spraying or dipping Location: ❑ Storage of combustible fibers Location: Types, ❑ Storage of scrap tires /etc. ❑ Organic coatings T pes: ❑ Places of assembly Location: Dates & Times: Location: ❑ Temp. membrane structures, tents, and canopies Location: Date & Times: ❑ Private fire hydrants Location: ❑ Pyrotechnic special effects material (Fireworks) Location: ❑ Tire- rebuilding plants Location: ❑ Use /Storage of compressed gases Location: Types: ❑ Pyroxylin plastics Types: ❑ Refrigeration equipment Types: Types: ❑ Waste handling Types: ❑ Wood products Types: ❑ Repair garages /motor fuel dispensing Location: ❑ Rooftop heliports Location: Additional Information: 3 04/14/2008 08:14 208- 535 -1079 EAGLE ROCK BLASTING Q CITY OF _ R.EXBURG AMEPLICA5 FAMILY COMMUNITY PAGE 01 OPERATIONAL PERMIT" APPLICATION PERMIT #: —LLB I 'L — r- 7 By: e�r Date: � 10 p � $50.00 FEE PAID: YES /NO PERMIT APPROVED: YES /NO �l 5 04 BY DATE: Owner Information Parcel Number: Owner: B y� ���, l�l, �� - � Number: X60 070$ Owner Mailing Address: 10:7 Property Address: 11 a 61I�� DIE' Cell /Office Number: 7 — Business Name Where Work Will Be Done: Coi m) Office Address: Office Phone Number: Applicant Information Name: I- c;r.h. Hu,,.se Contact Person: Contact Phone #: Name of Business: g IkS . OF Address: '255 F—, 5- �Jt ' ��o►�o F& I(, —12 $3LK)a Contact Person: c PHONE NUMBER:. 5a4" T CELL# 6� a7Mg Parade Route l Assembly Location: (Map required for Parades) APPLICANTSAIGNATURE DATE i■■ rr■■■■■■■■■■■■ rr■■■■■■■■■■■■■ rr■■■■■■■■■■■■■■■■■■■ r■■ ■■ ■r■rr■r■�■■ ■■r■ ■ ■r 1 19 E. Main St. Phone: 208- 359 -3020 x322 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.ora cdd §rexburg.org 04/14/2008 08:14 208- 535 -1079 Permit I PLEASE CHECKTHE TYPE OF PERMITS YOU ARE ❑ Aerosol product manufacturing List of contents: ❑ Combustible dust - producing operations Location: Type of dust: ❑ Covered mall buildings Location: ❑ Cryogenic fluids Types: ❑ Cutting and welding operations Location: ❑ Dry Cleaning plants Location: Types of Chemicals: ❑ Exhibits and trade shows Location: Type of Fire Extinguishers &Location: Explosives Location: DYlk Types: cot -15 - 110.d , vN Exflcd,vr>e5 ❑ Fire hydrants and valves Locations: Types: ❑ Flammable and combustible liquids Types: ❑ Floor finishing Types: ❑ Fruit and crop ripening Locations: Types: ❑ Fumigation and thermal insecticidal fogging Locations: Types: EAGLE ROCK BLASTING PAGE APPLYING FOR: ❑ Hazardous materials Locations: Types: ❑ High -piled storage Location: Contents: ❑ Hot work operations Location: Dates & Times of Operation: ❑ HPM facilities Location: p Industrial ovens Location: Types: ❑ Large capacity battery systems Location: Type: ❑ Liquid/gas vehicles /equip. in assembly buildings Location: Type: ❑ LP gas transportation Location: Type: ❑ Lumber yardsiplants Location: ❑ Magnesium work Location: ❑ Misc. combustible storage Location: Type: ❑ Open burning Location: Time & Date: ❑ Open flamesltorches Location: Time & Date: ❑ Operating amusement buildings Location: 2 04/14/2008 08:14 208- 535 -1079 EAGLE ROCK BLASTING PAGE 03 Operating aviation facilities Location: ❑ Operating carnivals or fairs Location: Dates & Times: Organic coatings Types: 0 Places of assembly Location: Dates & Times: ❑ Private fire hydrants Location: ❑ Pyrotechnic special effects material (Fire works) Location: Types: ❑ Pyroxylin plastics Types: ❑ Refrigeration equipment Types: ❑ Repair garages /motor fuel dispensing Location: ❑ Rooftop heliports Location: ❑ Spraying or dipping Location: ❑ Storage of combustible fibers Location: Types: ❑ Storage of scrap tires /etc. Location: ❑ Temp. membrane structures, tents, and canopies Location: Date & Times: ❑ Tire - rebuilding plants Location: ❑ Use /Storage of compressed gases Location: Types: ❑ Waste handling Types: ❑ Wood products Types: Additional information: 3