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HomeMy WebLinkAbout20112373.tiffRESOLUTION RE: APPROVAL OF SPECIAL EVENTS PERMIT ISSUED TO MEAD ROTARY CLUB FOUNDATION, AND AUTHORIZE CHAIR TO SIGN WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, The Mead Rotary Club Foundation, 16931 Potts Place, Mead, Colorado, 80542 presented to the Board of County Commissioners of Weld County, Colorado, an application for a Special Events Permit for the sale of 3.2% fermented malt beverages for consumption by the drink on the premises only, and WHEREAS, said applicant has paid the sum of ONE HUNDRED DOLLARS ($100.00) to Weld County, Colorado, pursuant to the laws providing therefore in payment for a County Retail Permit for the sale of 3.2% fermented malt beverages for consumption by the drink on the premises only, for an event scheduled for one day only on September 24, 2011, from 8:00 a.m., to 8:00 p.m., outside the corporate limits of any town or city in the County of Weld at the location described as follows: 6105 County Road 32, Platteville, Colorado 80651, being more fully described as the SW1/4 of Section 18, Township 3 North, Range 67 West of the 6th P.M., Weld County, Colorado WHEREAS, said applicant has also paid the sum of TWENTY-FIVE DOLLARS ($10.00) to the Colorado Department of Revenue and has exhibited a State Special Events Permit for the sale of 3.2% fermented malt beverages for consumption by the drink on the premises only. NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of Weld County, Colorado, having examined said application and the other qualifications of the applicant, does hereby grant Special Events Permit Number 2011-17 to said applicant to sell 3.2% fermented malt beverages for consumption by the drink on the premises only, only at retail at said location; and the Board does hereby authorize and direct the issuance of said permit by the Chair of the Board of County Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which permit shall be effective from 8:00 a.m., to 8:00 p.m., on September 24, 2011, providing that said place where the permitee is authorized to sell 3.2% fermented malt beverages for consumption by the drink on the premises only, shall be conducted in strict conformity to all of the laws of the State of Colorado and the rules and regulations relating thereto, heretofore passed by the Board of County Commissioners of Weld County, Colorado, and any violations thereof shall be cause for revocation of the permit. (Le, : 5L), APO - 9 -al li 2011-2373 LC0022 SPECIAL EVENTS PERMIT - MEAD ROTARY CLUB FOUNDATION PAGE 2 BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 7th day of September, A.D., 2011. BOARD OF COUNTY COMMISSIONERS WELD CUNTY, CDO ATTEST:�7�et. Weld County Clerk to the Board APPROVED AS -TO FORM: Barbara Kirkmeyer, Chair Sean P..,fca? way, Pro-Tem Date of signature: q 2011-2373 LC0022 ormr.c.c.c.cmcmc---ncrem.c.mq r/ 1 0 w o d9• � 'b � p � w � o L Ln 1 O V v p N w (2'� C1 o v j 1 may; �o e 'V ►�' ' -n `..� IL) 1 e� %I 1 cy-1 CJ�ernaGJ'FJ'-iC�_J�GJ�nGJ�FJ'JCJ'-G7% 0 0 66 4 N N W w W C!) Cn W z w II W e9 z H O z TO BE POSTED IN A CONSPICUOUS PLACE. DR 8427 (10/29/07) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 1881 PIERCE STREET, SUITE 108 LAKEWOOD, COLORADO 80214 STATE OF COLORADO DEPARTMENT OF REVENUE VALID ONLY FOR THIS ORGANIZATION AT THIS LOCATION MEAD ROTARY CLUB FOUNDATION 6105 WCR 32 PLATTEVILLE CO 80651 License Number JE-12-85406-0002 SPECIAL EVENTS PERMIT 3.2% FERMENTED MALT BEVERAGE VALID ONLY FOR THE FOLLOWING PERIODS FROM Date SEPT 24, 2011 Hour 8:00 AM TO Date SEPT 24, 2011 Hour 8:00 PM FROM Date XXXXXXXXXX Hour XXXXXXX TO Date XXXXXXXXXX Hour XXXXXXXX This permit is issued subject to the laws of the State of Colorado and especially under the provisions of Title 12, Article 48, Colorado Revised Statutes. This permit is non -transferable. It is issued only for the specific location described above, and must be conspicuously posted at that location. In testimony whereof, I have hereunto set my hand and seal 09/20/11 CAC LIO OR ENFORCEMENT DIRECTOR EX&QUTIVE DIRECTOR DR 8439 (06/28/06) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION 375 SHERMAN STREET DENVER CO 80261 (JU3) ZU5-ZJUU IN ORDER TO QUALIFY FOR A SPECIAL EVENTS PERMIT, YOU MUST BE NONPROFIT AND ONE OF THE FOLLOWING (See back for details.) III SOCIAL ATHLETIC 25 PHILANTHROPIC INSTITUTION • FRATERNAL MI CHARTERED BRANCH, LODGE OR CHAPTER M POLITICAL CANDIDATE El PATRIOTIC OF A NATIONAL ORGANIZATION OR SOCIETY MUNICIPALITY OWNING ARTS MI POLITICAL RELIGIOUS INSTITUTION FACILITIES LIAB TYPE OF SPECIAL EVENT APPLICANT IS APPLYING FOR: 2110 n MALT, VINOUS AND SPIRITUOUS LIQUOR $25.00 PER DAY 2170 CZ FERMENTED MALT BEVERAGE (3.2 Beer) $10.00 PER DAY DO NOT WRITE IN THIS SPACE LIQUOR PERMIT NUMBER 1. NAME OF APPLICANT rneeta �ORGANIZATION OR POLITICAL CANDIDATE ko-bs (Lb Fou.t&cc\lnw State Sales Tax Number (Required) Nov. (1.e.vrti SO) 2. MAILING ADDRESS OF ORGANIZASN OR POLITICAL CANDIDATE (include street, city/town and ZIP) llvU)1 I (o°‘3 1 P0-45 Place ',Ant ea? Co. ICc0S`4 Z 3. ADDRESS OF PLACE TO HAVE SPECIAL EVENT (include street, city/town and ZIP) 6l oS w ca 3 Z 2‘. ve„. it -e , Co. to(oSI NAME DATE OF BIRTH HOME ADDRESS (Street, City, Slate, ZIP) PHONE NUMBER 0. PRES./SEC'Y OFI�ORG. or POLITICAL CANDIDATE D 4Y.. e4..., 1217 . , Ae41es Gc . l,ay.gyn a leoIgg0old C t) ' D 5-0- 6. HAS APPLI T ORGANIZ N OR POLITICAL CANDIDATE BEEN ISSUED r�A S IAL EVENT IT THIS CALENDAR YEAR? AI NO YES HOW MANY DAYS? 7. IS PREMISES NOW LICENSED OUNDER CATE LIQUOR X NO n YES TO WHOM? OR BEER CODE? 8. DOES THE APPLICANT HAVE POSSESSION OR WRITTEN PERMISSION FOR THE USE OF THE PREMISES TO BE LICENSED? II Yes No LIST BELOW THE EXACT DATE(S) FOR WHICH APPLICATION IS BEING MADE FOR PERMIT Date 912`(I II Hours From f(;OO Am. To 1t100 p.m. Date Hours From m. To .m. Date Hours From .m. To m. Date Hours From m. To .m. Date Hours From .m. To m. OATH OF APPLICANT I declare under penalty of perjury in the second degree that I have read the foregoing application and all attachments that all information therein is true, correct, and complete to the best of my knowledge. thereto, and SIGNATURE i . TITLE A 4- DATE i 1yIII L ORT AND AP VAL OF LOCAL LICENSM AUTHORITY (CITY OR COUNTY) The foregoing ap tion has been examined and the premises, business conducted and character of the applicant is satisfactory, and we do report that such permit, if granted, will comply with the provisions of Tit e 12, Article 48, C.R.S., as amended. THEREFORE, THIS APPLICATION IS APPROVED. LOCAL LICENSING AUTHORITY (CITY OR COUNTY)• CITY Weld County, Colorado QJ COUNTY TELEPHONE NUMBER OF CITY/COUNTY CLERK (970) 356-4000 Ext 4225 sICNATURF--- ) C------- I TITLE Sean P. Conway, Pro-Tem ✓ DAttp - r 2011 r� -� , Board of County Commissioners DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY LIABILITY INFORMATION License Account Number Liability Date State TOTAL $ • -750 (999) APPLICATION FOR A SPECIAL EVENTS PERMIT Department Use Only (Instructions on Reverse Size) Cc' 2011-2373 SPECIAL EVENT PERMIT QUESTIONNAIRE AND AFFIDAVIT 1. What type of an event is planned (e.g., annual, quarterly, benefit, etc.)? 4\nvnua‘ 2. Explain in detail the nature of your organization, its function, and who or what benefits from its operations (attach separate sheet if necessary). 3. Who or what organization will be the recipient of funds derived from this event? rctok R Clain �v tw.daA-a� 4. How many attendees are expected at this event? 3o D 5. Describe the premises at which this event will take place. 6. What type of security will be provided at this event? PI‘i.).42.- Sec, ,t,4L c S k2in it/ s fr (V.\o (aaw�t.) 7. How many security personnel will be on hand? 2 8. How will security personnel be identified? Qtrice S. 9. If this event is being held outdoors, how will the exterior boundaries of the premises be marked (e.g., roped, fenced, etc.)? 10. What type of entertainment will be provided, if any, for this event? ovs.¢- 11. What method will be used in checking identification for proper age of attendees (e.g., at the door, at the bar, etc.) and how will underage patrons be identified so as not to be served alcoholic beverages (e.g., stamp or mark on the hand, etc.) trtu.('S ^tc0lrlbs2. (0 t -tai ( i) ( cat Da,4aC) M:\CTB\CTBFORMS\FOSPECIALEVENT.DOCSpecia (Event 12. How will the conduct and level of intoxication of atten ee�sbe monitored and by w�}om? VlSu.4 h41, "kw.o,c,>,a yY`Qr•PP .`p cv- C h VY1� IoeC5 13. Have volunteers or members of your organization been trained in the sale/service of alcoholic beverages: If yes, what training have they received and by whom? \ea,,r, iJ `Jca yas; C' LiPJA 5 . for & p rte.; i 14. What types of alternate beverages and food/snacks will be available? w 0-irt POP Co oo 15. Has a State Sales Tax Number been initiated by you or a member of your organization? If so, write that number in the space provided. Mot. Ste,,, , — Cc> 16. Explain how this event will be marketed describing what kinds of advertising material will be distributed and the targeted recipients of such material. I� ` C L.10 Pry _'c wy s I hereby certify, under penalty of perjury, that the information provided to the Board of County Commissioners of Weld County contained in this affidavit is true and accurate to the best of my knowledge. STATE OF COLORADO ) ss COUNTY OF WELD Subscribed and sworn to before me this Date 7 It S I I/ day of CI Witness my hand and official seal. My commission expires: O, Wit��• 7c�P PyT OF Bo`oP My Commission Expires: 03/15/2012 Ty Pub c 20 H. 3 -, etc/.Z M:\CTBICTBFORMSIFOS PECIALEVENT. DOCSpecialEvent OFFICE OF THE SECRETARY OF STATE OF THE STATE OF COLORADO CERTIFICATE I, Scott Gessler, as the Secretary of State of the State of Colorado, hereby certify that, according to the records of this office, Mead Rotary Club Foundation is a Nonprofit Corporation formed or registered on 10/02/2008 under the law of Colorado, has complied with all applicable requirements of this office, and is in good standing with this office. This entity has been assigned entity identification number 20081524989. This certificate reflects facts established or disclosed by documents delivered to this office on paper through 07/13/2011 that have been posted, and by documents delivered to this office electronically through 07/15/2011 @ 06:24:05. I have affixed hereto the Great Seal of the State of Colorado and duly generated, executed, authenticated, issued, delivered and communicated this official certificate at Denver, Colorado on 07/15/2011 @ 06:24:05 pursuant to and in accordance with applicable law. This certificate is assigned Confirmation Number 7994772. Secretary of State of the State of Colorado *********************************************End of Certificate******************************************** Notice: A certificate issued electronically from the Colorado Secretary of State's Web site is fully and immediately valid and effective. However, as an option, the issuance and validity of a cert f Cate obtained electronically may be established by visiting the Certificate Confirmation Page of the Secretary of State's Web site, lutp://www.sos.state.co.usibiz/Certi/icaleSearchCriteria.do entering the certificate's confirmation number displayed on the certificate, and following the instructions displayed. Confirming the issuance of a certificate is merely optional and is not necessary to the valid and effective issuance of a certificate. For more information, visit our Web site, hup../Avinv.sos.state.co.us/ click Business Center and select "Frequently Asked Questions." CERT GS D Revised 08'20/2001 Rotary Club of Mead P.O. Box 66 Mead, CO 80542 July 15, 2011 Board of County Commissioners 915 10t" Street Greeley, CO 80631 Re: Mead Sugarbeet Festival Dear Commissioners, Dan Dean and Nick Sekich have been appointed chair persons for the 6th Annual Mead Sugarbeet Festival to be hosted by the Rotary Club of Mead. This event is to be held on September 24, 2011 on the Sekich property. The Rotary Club of Mead will be the legal permit holder for this event. We have applied for the necessary paperwork and we are asking for a deference of the performance bond listed in Section 12-1-30 of the Weld County Code because Nick Sekich will be cleaning up on his own property. We have applied for insurance for the event and we will fax or email this bindingof coverage when we receive it from the agency. We invite the Weld County Commissioners to participate in the years Sugarbeet Festival with and informational both and attendance at the festival. We will waive the booth fee if you decide to be part of this community event. Respectfully, 'n 04(01 Dan Dean President Rotary Club of Mead NICK SEKICH 6790 WCR 32 Platteville, CO 80651 July 15, 2011 RE: Sugarbeet Festival, State of Colorado Liquor License To whom It May Concern: I, Nick Sekich, am aware of and in support of the Mead Rotary Sugarbeet Festival that will be taking place on Sekich Properties on September 24, 2011. I am a member of the Mead Rotary Club and an one of the sponsors of the event. This event has my full support to take place on my property. Please call if you have any questions. Sincerely, -n , Nick Sekich i Pt, se, COLORADO MEMORANDUM To: Esther Gesick, Deputy Clerk to the Board August 5, 2011 From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services Subject: LC0022 Review of the following Temporary Assembly Permit by the Department of Planning Services shows the following: Applicant: Mead Rotary Club Foundation 16931 Potts Place Mead, Co 80542 Property Owner: Nick Sekich 6790 CR 32 Platteville, Co 80651 Location of Event: 6105 Weld County Road 32 Platteville, Colorado 80651 (Event to take place on September 25, 2010) Dates and Time of Event: September 24, 2011, 8:00 a.m. - 8:00 p.m. General Information: Zone District: Comments: Agriculture • Question #4 (TA) states 250 as the maximum number of people; however, question #5 (TA) does not explain how this number will be enforced. Furthermore, question #12 (TA) calls out parking for 300 vehicles. Question #4 (SE) states 300 as the maximum number of people. • There are no outstanding violations on this site and staff has no issues with issuance of this "Temporary Assembly Permit". TA = Temporary Assembly application SE= Special Events application SERVICE, TEAMWORK, INTEGRITY, QUALITY COLORADO Memorandum TO: Esther Gesick, CTB From: Dan Joseph, Environmental Health Specialist DATE: September 2, 2011 SUBJECT: Temporary Assembly Permit for LC0022 In response to your request, Environmental Health Services has reviewed the Special Events Permit and Temporary Assembly Permit, LC0022, for the Mead Rotary Club Foundation located at 6105 County Road 32, in Platteville, Colorado. At this time the Department does not have any concerns. However, the Department would like to request that the operator/s of the food booths contact the Department to discuss food operations that are to occur onsite. Should you have any questions regarding this matter, please contact me at extension 2206 or via e-mail at diosephna,co.weld.co.us. Thank you. CC: Cindy Salazar, Environmental Health Services Debra Adamson, Environmental Health Services Esther Gesick From: Sent: To: Cc: Subject: Esther Gesick Friday, September 02, 2011 4:05 PM Terry Enright Esther Gesick FW: Mead Rotary Temp Assembly/Special Event Permit Terry, Please see comment below. Thanks! PLEASE NOTE ADDRESS CHANGE BELOW Esther E. Gesick Deputy Clerk to the Board/Office Manager 1150 O Street, P.O. Box 758/Greeley, CO 80632 tel: (970) 336-7215 X4226 1/{I.101 WE i'&u/C dV N1r Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Jonathan Gesick Sent: Friday, September 02, 2011 11:28 AM To: Esther Gesick Subject: RE: Mead Rotary Temp Assembly/Special Event Permit The building department has no issues with the permit. Jonathan D Gesick Plans Examiner/Building Inspector Planning 1555 N 17th Ave Greeley, CO 80631 tel: (970) 353-6100 x3532 WE N W El1f1COV NAY u Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise 1 protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Esther Gesick Sent: Friday, September 02, 2011 11:05 AM To: Dan Joseph; Jonathan Gesick; Roy Rudisill Subject: Mead Rotary Temp Assembly/Special Event Permit Dan, Jonathan, and Roy, Just a friendly reminder I need to get your referral responses back regarding the Mead Rotary Sugar Beet Festival so the applicant can try to address any concerns prior to the meeting scheduled for next Wednesday (9/7/11). Thanks! PLEASE NOTE ADDRESS CHANGE BELOW Esther E. Gesick Deputy Clerk to the Board/Office Manager 1150 O Street, P.O. Box 758/Greeley, CO 80632 tel: (970) 336-7215 X4226 wECC1 EoV NTY u Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. 2 MEMORANDUM TO: Christie Peters, Clerk to the Board DATE: 08/8/11 FROM: Janet Carter E.I., Public Works SUBJECT: Temporary Assembly Mead Rotary Club Foundation The Weld County Public Works Department has reviewed this proposal. Our requirements are as follows: REQUIREMENTS: 1. No parking will be allowed on Weld County Roadways. 2. Approximately 300 vehicles will require parking on the property. 3. Use the existing access off WCR 13 instead of WCR 32. 4. Please submit a Traffic Control Plan (TCP) prepared by a certified Traffic Control Supervisor (TCS) 5. This area is not in a Special Flood Hazard Area (SFHA) as determined by the Federal Emergency Management Agency (FEMA). 6. Please submit an Incident Command Plan for the Office of Emergency Management. Page - 1 - of 1 August 8, 2011 CADocuments and Settings\egesick\Local Settings\Temporary Internet Files \ContentOutlook\MAM2CSX8\Temp Assembly Mead Rotary Club Sekich 2011 (2).DOC Esther Gesick From: Sent: To: Subject: Roy Rudisill Friday, September 02, 2011 2:05 PM Esther Gesick RE: Temp Assembly & Special Events Request Esther, I have sent a message to representatives with Mt View Fire and WCPS to see if they have any concerns with this event. I have confirmed that the Sheriffs Office Posse and Reserves will be providing security for the event. The only item that stood out is the number of attendees, on the permit application it states 250, on the liquor license permit is indicates 300. Is the assembly permit required due to the request for the liquor license? Roy Radish!! Director Weld County Sheriff's Office Office of Emergency Management Terrorism Liaison Officer 970-304-6540 Office 970-381-0417 Cell www.weldsheriff.com * inbwrovf Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise protected from disclosure. If you have received this communication in error, please immediately notify sender by return e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited. From: Esther Gesick Sent: Tuesday, August 16, 2011 11:03 AM To: Roy Rudisill Subject: FW: Temp Assembly & Special Events Request Roy, In looking at Christie's e-mail, it looks like she inadvertently sent this to the wrong "Roy". Sorry about the delay, but the event is not until 9/24 and won't be considered by the BOCC until 9/7, so don't worry about the referral deadline; just send it through when you have it done. Let me know if you need anything else. Thanks! PLEASE NOTE ADDRESS CHANGE BELOW Esther E. Gesick Deputy Clerk to the Board/Office Manager 1150 O Street 1 TEMPORARY ASSEMBLY REVIEW FORM Date: August 1, 2011 TO: Deputies Lisa Carpenter and Jeremy Frey FROM: CTB SUBJECT: Temporary Assembly/Special Events Permit Check Please review all records on the following property for any associated reports during the last year and return your report to the Weld County Clerk to the Board's Office within seven days. Your report will be used by the Board of County Commissioners in considering issuance of a Temporary Assembly Permit. A copy of the file will be attached in .pdf format, for your review. PLEASE RESPOND NO LATER THAN: AUGUST 12, 2011 APPLICANT: MEAD ROTARY CLUB FOUNDATION EVENT LOCATION: 6105 WELD COUNTY ROAD 32 PLATTEVILLE, COLORADO 80651 EVENT DATE: SEPTEMBER 24, 2011, FROM 8:00 A.M. - 8:00 PM ***************************************************************** No concerns Dep""P'"nitials The Sheriffs Office had a concern and the deputy has mutually worked with the property owner to correct the concern. (Complete Attached Worksheet) Unresolved concerns exist requiring a Probable Cause Hearing scheduled by the Board of County Commissioners. (Complete Attached Worksheet) ******************************************************************************************a ka********* Please notify at Extension Board of Commissioner's Temporary Assembly hearing. of the date and time of the Temporary Assembly Worksheet The following concerns are noted: The property owner and the Sheriffs Office have collectively agreed to implement the following to correct concerns noted above: (A time line and corrective action should be listed for each concern) g (/ Property Owner, Please Print Date Property Owner Signature "Deputy's Sigithture Use another sheet of paper or attach separate proposal to this packet if needed. Attach copies of all reports associated with this property for the last year. Both the Deputy and the Owner of the establishment will be required to attend the Temporary Assembly Hearing to testify to the above agreement. PURSUANT TO TIE LIQUOR LAWS NOTICE OF COLORADO Mao 1LTAEY CLUB rownyAT1& 1031 'Pont ?Vice MEAD , CO so541z -- HAS REQUESTED TIE LICENSING OFFICIO OF VELD COW -Tv, Coto010o TO CousRUEt A SPECIAL Evewrs LICENSE AT: (005 CourJTy ROAD 3z �iv�u.E , CO SO�v51 , A ON APPLICATION TO BE HELD AT: WELD Cou ry Atri,hUISTRATO4 t'BUILbIikm ABLY 150 0 stun-, G rye'. C TIME AND DATE: q cx) Am - , 20 on OF APPLICATION: By O $R OF: WEw Couuw recARD of e 1SSIomen OFFS; Nlct SEKICH TERRY ENRI GHT HAS REQUESTED TIE LIWISING arms Of `'M tD Cou�;,r, 10 hS ,,, «� k A SPEun Ev ,32 LICENSE AT: (a Io5 C0W 1 46"° HArTh,,,ue, CD A Al: IS 41W HEARING ON APPUCAT TO �„ �y 41Couury Awn, aistow" 1150 O ,rtter, �acttev. �� 3� l AND DATE:q co P . 20 A OF ORSe DER OF T ff fl of sw 11aiviss :L. �EKKH vev GNizir,Nr ,1 IAA" N M CO CO 0 O .0 O N U • m cameo o y U — o a' -o Y m 0 ° N O 2 a0'Q Cal0 0 O .o N o U 0 0 m co c a) r- O • r- 0 • ° o aTi -0Ym v 3W RECEIPT RECEIVED FROM ADDRESS FOR DATE 2- 021) 1l NO.86007 ladyked v- oo/lw Q !✓uAnt-1 inaL HOW PAID CASH SHACK HONEY Inn RECEIPT ECEIVED FR DQRESS ito *D BY DATE Q g - I5 -cap II NU. NO.86008 Merl c1P-c NameCAL(b 1 v fr Ph: Special Event Date Referrals sent Environmental Health Planning Services Sheriff's Office* Public Works Emergency Services* Date Referrals received- - 2 —Environmental Health -2 Planning Services/&I `Sheriffs Office 9 z Public Works 61- Z Emergency Services Application N Special Events Questionnaire & Affidavit N Diagram of the Area NJ Certificate of Good Standing (Non -Profit) N Copy of Deed, Lease, or Letter of Consent \ Copies of Receipts for County and State BOCC Meeting Date Prepare Sign Posting** 8/9(p Call Applicant to pick up sign Photo of Sign Posted by Applicant*** Draft Special Events Permit Reso Print Final Reso Ensure Sent to State at Least 10 Days Prior to the Event *Receives a Copy of the Application **Must be posted 10 days prior to hearing ***May turn in Day of Hearing Soto -0-7).g cc: Brad NO PUBLICATION IS J QUIRED Mtg Date Event Datg, $100 PD (.(0 U/t{) Amt State Void State Weld County and State of Colorado Special Events Permit and Temporary Assembly Permit for Mead Rotary Club were picked up in person by Terry Enright on September 23, 2011. Terry Enright Witnessed by JLo-y„, Deputy(lerk to the B'dard Hello