HomeMy WebLinkAbout20100258 • SITE SPECK DEVELOPMENT PLAN AND UY SPECIAL i_ '_-`'_.____
REVIEW (USR) APPLICATION
FOR PLANNING DEPARTMENT USE DATE RECEIVED:
RECEIPT#/AMOUNT# /$ CASE#ASSIGNED:
• APPLICATION RECEIVED BY PLANNER ASSIGNED:
Parcel Number 1 3 \ \ - el/ - 0 - O0 - 0 0
(12 digit number-found on Tax^ I.D.''inforrm�ation,obtainable at the Weld County Assessor's
ssessor's Office,or www.co.weld.co.us1
Legal Description Q01+. O1- 'I Q J .,41/1 Va 01- , Section2Y, Township 2 North, Range 1o7West
Flood Plain:868 r,} 1015 Zone District: AG , Total Acreage3.2-S + , Overlay District: ._
Geological Hazard: — , Airport Overlay District: —
FEE OWNER(S)OF THE PROPERTY: n
Name: Sand fa) bork]rQ Kakottp5d,
Work Phone# Home hone#3u- •9'51. 1999 Email 11111,)P4us1959aQnG. er)m
Address: II'+lo`7 1 eI l'1tiRhy 18 dl
Address:
City/State/ZipCode—floRT L& s\nn i en goon-1
Name:
Work Phone# Home Phone# • Email
Address:
Address:
City/State/Zip Code
Name:
• Work Phone# Home Phone# Email
Address:
Address:
City/State/Zip Code
APPLICANT OR AUTHORIZED AGENT(See Below:Authorization must accompany applications signed by Authorized Agent)
Name:
Work Phone# Home Phone# Email
Address:
Address:
City/State/Zip Code
PROPOSED USE:
Ta-N1 {-' fr C>At sunne.Q , di, t
I (We) hereby depose and state under penalties of perjury that all statements, proposals, and/or plans submitted
with or contained within the application are true and correct to the best of my(our)knowledge. Signatures of all fee
owners of property must sign this application. If an Authorized Agent signs, a letter of authorization from all fee
owners must be included with the application. If a corporation is the fee owner, notarized evidence must be
included i dicati tha signato as to legal authority to sign for the corporation.
• S �
signature: Owner or Authorized Agent Dat Signature: Owner or Authorized Agent Date
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EXHIBIT
I2 2010-0258
• •
SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL
• REVIEW(USR) QUESTIONNAIRE
The following questions are to be answered and submitted as part of the USR application. If a question does not
pertain to your use, please respond with "not applicable", with an explanation as to why the question is not
applicable.
1. Explain, in detail, the proposed use of the property.
2. Explain how this pro sal is consistent with the intent of the Weld County Code, Chapter.22 of the
Comprehensive Plan.
3. Explain how this proposal is consistent with the intent of the Weld County Code, Chapter 23(Zoning) and
•the zone district in which it is located.
4. What type of uses surrounfi the site(explain how the proposed use is consistent and compatible with
surrounding land uses).N/A
5. Describe, in detail, the following:
a. 2 Number of people who will use this site n^04WOJnQJ
b. Number of employees proposed to be employed at this site KJI
c. Hours of operation/tJ'f
d. Type and number of structures to be erected(built)on this site A'8 J
• e. Type and number of animals, if any, to be on this site tl 5i eak, brcis, hotSPS
f. Kind of vehicles(type, size, weight)that will access this site and how often-Nan, 3cap, F ISO
g. Who will provide fire protection to the site hyres$-one
h. Water source on the property(both domestic and irrigation)Ule t
I. Sewage disposal system on the property(existing and proposed) spa `* n,\L
j. If storage or warehousing is proposed, what type of items will be stored A j a
i
6. Explain the proposed landscaping for the site. The landscaping shall be separately submitted as a
landscape plan map as part of the application submittal.N n
7. Explain any proposed reclamation procedures when termination of the Use by Special Review activity
occurs. (fl
8. Explain how the storm water drainage will be handled on the site.PYft WM- 'acM Wr/iP'Y
9. Explain how long it will take to construct this site and when construction and landscaping is scheduled to
begin. Nth
10. Explain where storage and/or stockpile of wastes will occur on this site. Ns
• -7-
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• Animal Clinic, LLC •
232 1st Street
Fort Lupton, CO 80621
(303)857-6671
Rabies Certificate
Patient ID: 9619
Client ID: 7856065
Patient Name: DODGER
Client Name: Sandy Rakowski
Species: Canine
Address: 11467 WCR 18
Breed: Spaniel, Cocker
Ft. Lupton, CO 80621
Sex: Neutered Male
Color: Buff
Phone: (303)931-7999 Markings:
Birthday: 07/07/2004
Weight: 24.20 pounds on 7/29/2009
Tag Number: 91010 Vaccination Date: 7/29/2009
Lot Number: 873178A Expiration Date: 7/29/2010
Producer: FORT DODGE
K/MLV: Killed Virus
Staff Name: Patrick Owen, DVM
• License Number: 6371
•
Animal Gnflc, LLI.
• 232 1st Street •
Fort Lupton, CO 80621
(303) 857-6671
• Rabies Certificate
Patient ID: 5865
Client ID: 7856065 Patient Name: MYSTIQUE
Client Name: Sandy Rakowski Species: Canine
Address: 11467 WCR 18 Breed: Retriever, Golden
Ft. Lupton, CO 80621 Sex: Spayed Female
Color: Gold
Phone: (303)931-7999 Markings:
Birthday: 12/10/2006
Weight: 81.60 pounds on 7/8/2008
Tag Number: 80798 Vaccination Date: 6/3/2008
Lot Number. 873178A Expiration Date: 6/3/2011
Producer: FORT DODGE
K/MLV: Killed Virus
Staff Name: Troy A. Dowdy, DVM
• License Number 7168
•
Animal Clinic, LLC
• 232 1st Street •
Fort Lupton, CO 80621
(303) 857-6671
•, Rabies Certificate
Patient ID: 5017
Client ID: 7856065 Patient Name: SARA
Client Name: Sandy Rakowski Species: Canine
Address: 11467 WCR 18 Breed: Beagle
Ft. Lupton, CO 80621 Sex: Spayed Female
Color: Tri-Color
Phone: (303)931-7999 Markings:
Birthday: 10/25/2004
Weight: 31.00 pounds on 2/9/2009
Tag Number: 80796 Vaccination Date: 6/3/2008
Lot Number: 873178A Expiration Date: 6/3/2011
Producer: FORT DODGE
K/MLV: Killed Virus
Staff Name: Troy A. Dowdy, DVM
• License Number. 7168
•
Animal Clinic, LLU
• 232 1st Street •
Fort Lupton, CO 80621
(303) 857-6671
• Rabies Certificate
Patient ID: 3995
Client ID: 7856065 Patient Name: XENA
Client Name: Sandy Rakowski Species: Canine
Address: 11467 WCR 18 Breed: Retriever, Golden
Ft. Lupton, CO 80621 Sex: Spayed Female
Color Gold
Phone: (303)931-7999 Markings:
Birthday: 12/01/2004
Weight: 82.20 pounds on 8/13/2007
Tag Number: 80795 Vaccination Date: 6/3/2008
Lot Number: 873178A Expiration Date: 6/3/2011
Producer: FORT DODGE
K/MLV: Killed Virus
Staff Name: Troy A. Dowdy, DVM
• License Number. 7168
•
Animal Clinic, LLC
• 232 1st Street •
Fort Lupton, CO 80621
(303) 857-6671
Rabies Certificate
Patient ID: 3857
Client ID: 7856065 Patient Name: CHIEF
Client Name: Sandy Rakowski Species: Canine
Address: 11467 WCR 18 Breed: Retriever, Golden
Ft. Lupton, CO 80621
Sex: Neutered Male
Color: Gold
Phone: (303)931-7999 Markings:
Birthday: 09/27/2004
Weight: 81.00 pounds on 2/26/2007
Tag Number: 80794 Vaccination Date: 6/3/2008
Lot Number 873178A Expiration Date: 6/3/2011
Producer FORT DODGE
K/MLV: Killed Virus
Staff Name: Troy A. Dowdy, DVM
• License Number 7168
•
• INVOICE
AmericaOutdoorcom 3430180
303.670.915 Invoice Date Page
4/13/2009 14:51:42 1 of 1
• ORDER NUMBER
Or�`�,� ------1431348
JY1 1
( Bill To: ‘1)2-1rat) Ship To:
AMERICA OUTDOOR.COMM N T SANDRA RAKOWSKI
11111 11467 COUNTY RD 18
USA FOR_LUPTON,CO 80621
- USA
Customer ID: 12443
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
S RAKOWSKI Net 60 06/12/09 06/12/09 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
4/13/2009 12:47:48 2428215 INTERNET SALES SFLOOD
- r
age
Quantities Pricing
UOM
Item ID Unit Extended
UOM o Item Description Price Price
Ordered Shipped Remaining G Unit Size
Unit Size
• Delivery Instructions: UPS NEXT DAY AIR SAVER FOR S39.65
( Carrier: Tracking#:
4, \. ., 3.0000 3.0000 )1.0000 EA BC-200 EA 67.9500 203.85
1.0 RECH.BARK COLLAR 1
RECHARGEABLE BARK COLLAR
Total Lines-I • SUB-TOTAL: 203.85
Total Freight In:0.00 Total Freight Out:39.65 TOTAL FREIGHT: 39.65
TAX: 0.00
AO CC: 243.50
CASH RECEIPTS: 0.01
AMOUNT DUE: -0.01
• ORIGINAL
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