HomeMy WebLinkAbout20081848.tiff SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL
REVIEW (USR) APPLICATION
• FOR PLANNING DEPARTMENT USE DATE RECEIVED:
RECEIPT#/AMOUNT# 1$ CASE#ASSIGNED:
APPLICATION RECEIVED BY PLANNER ASSIGNED:
�
Parcel Number / ,3 / _3 - b 1 - _0 -�2�Z - ...Q _/_
(12 digit number-found on Tax I.D. information,obtainable at the Weld County Assessor's Office,or www.co.weld.co.us).
Legal Description , Section I, Township 2 North, Range a West
Flood Plain: A.A. Zone District: WA_ , Total Acreage: 3.3 r- , Overlay District:
Geological Hazard: /lieti_ , Airport Overlay District:7A_
FEE OWNER(S) OF THE PROPERTY:
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Name:
' Work Phone# Home Pho Email Address:
• Address:
City/State/Zip Code
Name:
Work Phone# Home e # Email Address:
Address:
City/State/Zip Code
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v r�vci�t (See Below:Authorization must accompany applications signed by Authorized Agent)
Name: I '
Work Phone#3p3 (�3 q f-� Phone 3R3 5q) gel¢Email Address: AS
Address: 000 nassetySa/z/SJ4
City/State/Zip Code Egjo da ut'c
PROPOSED USE:
'VALE �u(n 4 e a.G,�. cnn�✓4C �a any
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 a lication. If a corporation is the fee owner, notarized evidence must be included
indicating that the si as t gal authority to sign for the corporation.
EXHIBIT
Signature: Owner Authorized gent j Date Signature: Owner or Authorized A 2
3
� � / J' �2 2008-1848
. .
• OFFICE OF THE SECRETARY OF STATE
OF THE STATE OF COLORADO
CERTIFICATE
I, Ginette Dennis, as the Secretary of State of the State of Colorado, hereby certify that,
according to the records of this office,
J.A.R.Holdings,LLC
is a
Limited Liability Company
formed or registered on 06/08/2006 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 20061235353 •
This certificate reflects facts established or disclosed by documents delivered to this office on
paper through 06/09/2006 that have been posted, and by documents delivered to this office
electronically through 06/14/2006 @ 11:32:51 .
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 06/14/2006 @ 11:32:51 pursuant to and in accordance with applicable law. This certificate is
assigned Confirmation Number 6514884 .
• y: et*." ,t!y
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Secretary._ .„, ...
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of State of the State of Colorado
End of Certificate
Notice:A certificate issued electronically from the Colorado Secretor-Lontate's Weksde idlully and immediately valid and effective. However,
as an option,the issuance and validity of a certificate obtained electronically may be established by visiting the Certificate Confirmation Page of
the Secretary of State's Web site, hap=^vww.sos.state.co.usbirlCertificateSearchCrtteria.do entering the certificates confirmation number
displayed on the certificate, and following the instructions displayed. Confirming the issuance
ourWeb site, certificate
lurt ica anvw isos"merely
copuo alcaBusinessl and is ot
necessary to the valid and effective issuance of a certificate. For more information,visit
Center and select "Frequently Asked Questions."•
• CERT_GS D Revised 09/22/2005
•
• ARTICLES OF ORGANIZATION
FOR COLORADO LIMITED LIABILITY COMPANY
J.A.R. HOLDINGS, LLC
Pursuant to Section 7-80-203, Colorado Revised Statutes (C.R.S. ) , the
individual named below, a natural person of at least 18 years of age, acting as
organizer, hereby causes these Articles of Organization to be delivered to the
Colorado Secretary of State, and states as follows:
ARTICLE I-Name
The name of the limited liability company is J:A.R. HOLDINGS, LLC.
ARTICLE II-Principal Place of Business
The principal place of business of the limited liability company is: 11621
County Road 13, Longmont, Colorado 80504 .
ARTICLE III-Registered Agent
The name, and the business address, of the registered agent for service of
process on the limited liability company are:
Name: DANIEL RODARMEL
Business Address: 11621 County Road 13, Longmont, CO 80504
ARTICLE IV-Management
The management of the limited liability company is vested in the managers.
The name and addresses of the initial manager is:
J.A.R. HOLDINGS, LLC, 11621 County Road 13, Longmont, CO 80504
ARTICLE V-Filing Information
The names and mailing addresses of the individuals who cause this document
to be delivered for filing, and to whom the Secretary of State may deliver notice
if filing of this document is refused are: Daniel Rodarmel, 11621 County Road 13,
Longmont, CO 80504 and Phillip S. Wong, PO Box 267, Longmont, CO 80501.
The Colorado Secretary of State may contact the following authorized person
regarding this document: Phillip S. Wong, P.O. Box 267, Longmont, CO 80501.
Voice: 303-776-3511; Fax: 303-772-2297; E-mail] Pwona8543@aol.com
E:\Data\wpdoca\ltdliab\Rodarmel-JARHoldings-Mgr.Art.wpd
• 1
Form SS-4 Application for Employer Identification Number
(For use by employers,corporations, partnerships,trusts,estates,churches, EIN 20-5041612
• (Rev. December 2001) government agencies, Indian tribal entities,certain individuals,and others.)
Department of the Treasury OMB No. 1545-0003
Internal Revenue Service ► See separate instructions for each line. ► Keep a copy for your records.
1 Legal name of entity(or individual) for whom the EIN is being requested
J.A.R. Holdings, LLC
t2 Trade name of business Of different from name on line 1) 3 Executor,trustee. "care of name
m Daniel Rodarmel
to
t1 4a Mailing address(room, apt., suite no. and street, or P.O. box) 5a Street address(if different) (Do not enter a P.O. box.)
c 11621 County Road 13
p, 4h City, state, and ZIP code 5b City, state, and ZIP code
p Longmont,Colorado 80504
N 6 County and state where principal business is located
Cl. Weld County,Colorado
7a Name of principal officer,general partner,grantor.owner,or truster lb SSN,ITIN,or ON
Daniel Rodarmel 521.64-0733
Ha Type of entity (check only one box) ❑ Estate (SSN of decedent)
LI Sole proprietor(SSN) - ❑ Plan administrator(SSN)
® Partnership ❑ Trust(SSN of grantor)
❑Corporation(enter form number to be filed) ► LI National Guard ❑ State/local government
❑ Personal service corp. ❑ Farmers'cooperative ❑ Federal govemment/milltary
❑Church or church-controlled organization LI REMIC ❑ Indian tribal govemments/enterprises
❑Other nonprofit organization (specify) ► Group Exemption Number(GEN) P.
❑ Other(specify) ►
Hb If a corporation. name the state or foreign country State Foreign country
(if applicable)where incorporated
9 Reason for applying(check only one box) ❑ Banking purpose(specify purpose) ►
®Started new business(specify type) ► ❑ Changed type of organization(specify new type) P.
Real Estate Investments ❑ Purchased going business
• ❑Hired employees(Check the box and see line 12.)E]Compliance
Created a trust(specify type) ►
Compliance with IRS withholding regulations ❑ Created a pension plan(specify type) ►
❑Other(specify) ►
10 Date business started or acquired (month, day, year) 11 Closing month of accounting year
June 14,2006 December
12 First date wages or annuities were paid or will be paid (month, day, year). Note: If applicant is a withholding agent, enter date income will
first be paid to nonresident alien. (month, day,year) ►
13 Highest number of employees expected in the next 12 months. Note: If the applicant does not Agricultural Household Other
expect to have any employees during the period, enter "-0- " I. 0 0 0
14 Check one box that best describes the principal activity of your business. ❑ Health care&social assistance ❑ Wholesale-agent/broker
❑ Construction ❑ Rental&leasing ❑ Transportation&warehousing ❑ Accommodation&food service ❑ Wholesale-other ❑ Retail
® Real estate ❑ Manufacturing ❑ Finance&insurance ❑ Other(specify)
is Indicate principal line of merchandise sold; specific construction work done; products produced:or services provided.
Real Estate Investments e,
16a Has the applicant ever applied for an employer identification number for this or any other business? ❑ Yes I No
Note: If"Yes,"please complete lines 166 and 16c.
166 If you checked "Yes" on line 16a. give applicant's legal name and trade name shown on prior application if different from line 1 or 2 above.
Legal name ► Trade name ►
16c Approximate date when, and city and state where, the application was filed. Enter previous employer identification number if known.
Approximate date when filed(mo.,day.year) City and state where filed Previous EIN
Complete this section only if you want to authorize the named individual to receive the entity's EIN and answer questions about the completion of this form.
Third Designee's name Designee's telephone number(include area code)
Party Heidi Ledesma, Legal Assistant ( 303 )776.3511
Designee Address and ZIP code Designee's fax number(include area code)
825 Delaware Ave,Ste 300 Longmont,Colorado 80501 ( 303 ) 772.2297
Under penalties of perjury,I declare that I have examined this appication.and to the best of my knowledge and befef.it is true,correct,and complete. % %
Appiran's telepnare number Pndcde area code)
• Daniel Rodarmel ( 303 ) 591.4514
Name and title(type or print clearly
Appicanfz fax number Unclude area code)
Signatu Date ► ( )
For Privacy Act and Paperwork Reduction Act Notice, see separate Instructions. Cat.No. 16055N Form SS-4 (Rev. 12-2001)
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# •
WELD COUNTY ROAD ACCESS INFORMATION SHEET
• Weld County Department of Public Works
111 H Street, P.O. Box 758, Greeley, Colorado 80632
Phone: (970 )356-4000, Ext. 3750 Fax: (970)304-6497
Road File#: Date: /L- 3-O%-
RE# : Other Case#:
1. Applicant Name 1/4.44 Z. IM-mnf(5 LGG • Phone 303 bit"$f-L?'
Address Ma I IAA.0.ft. /3 City 6mnscrh0itC State GO Zip s:05.01-
2. Address or Location of Access //&L! W-C.It- /3
Section Township Range Subdivision Block Lot
Weld County Road#: 13 Side of Road Ltye5T Distance from nearest intersection ''/ /ho,E
3. Is there an existing access(es)to the property? Yes 7IC No #of Accesses
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision ❑ Commercial ;if Other 5T0QAGE
•
****•,,,...***********...**.....*********..******....".*****...*...n...***,.....***...***...************.«...tr.•..**..******
***********************11:4*** *** *******..**************************i*i**#ofi4#i1******************1*****.«...I4i•1****..******
5. Site Sketch
Legend for Access Description:
AG = Agricultural Couury Rn• 2!0
H.
RES = Residential
• O&G = Oil&Gas
D.R. = Ditch Road
O = House
O = Shed
A = Proposed Access 4 Q
A = Existing Access C
Mw.SOADows
Nicfre o
v
FiRb5tO.crg gc.✓D.
OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized ❑ Information Insufficient
• Reviewed By: Title:
-9
FOR COMMERCIAL SITES, PLEASE COMPLETE THE FOLLOWING INFORMATION
BUSINESS EMERGENCY INFORMATION:
Business Name: ...77A. Go va LL4. Phone: 303- __'$'- 2?-
Address: !! b i l w•6. J •. 1'� City, sr, zip: La v4nw,yr ^^N1 La• 8.8504-
Business Owner Dili/ KGDAIZ.44 Phone: 3473 5g! ¢5(+
Home Address: ga0 131404144)&61;1/44,5).fr Si. City, ST, Zip: 4a1j..yr (?0uANS e4t0• 806&4
List three persons in the order to be called in the event of an emergency:
NAME TITLE ADDRESS PHONE
VA-Ai R wA9441 1.- Sop Xd,4tnny,t- 1 S1p SY F(., lth,,p• 303 -541 - 4514
�f I IZ Da Jufr2n 4}z(0 Luuicte Lai-ecipmi Coco. 303-54!• bZas
Business Hours: -7 %GO Am. / 5;00 /4,4 . Days: 5 M- F
Type of Alarm. None Burglar Holdup Fire Silent Audible
Name and address of Alarm Company:
iLocation of Safe: IVOP*
MISCELLANEOUS INFORMATION: 3
Number of entry/exit doors in this building: Location(s): etterri jet/Ole, ¢ Shalt'
Is alcohol stored in building? pp Location(s):
Are drugs stored in building? Imp Location(s):
Are weapons stored in building? A/0 Location(s):
The following programs are offered as a public service of the Weld County Sheriffs Office. Please indicate the programs
of interest. Physical Security Check Crime Prevention Presentation
UTILITY SHUT OFF LOCATIONS:
Main Electrical: f0N/en. f,c.ti
Gas Shut Off: D,P-�f pAwA tehv�
Exterior Water Shutoff: ler W&- , 151 14/641 DI lie
• Interior Water Shutoff:
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