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SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL
REVIEW (USR) APPLICATION
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FOR PLANNING DEPARTMENT USE DATE RECEIVED:
RECEIPT#/AMOUNT# 1$ CASE#ASSIGNED:
APPLICATION RECEIVED BY PLANNER ASSIGNED:
Parcel Number V g Q 3- 43-3 - 0 - 00 - O `_P_
(12 digit number-II found on Tax I.D. information,obtainable at the Weld County-- 3 Assessors Office,or www.co.weld.co.us).
Legal Description "f- 12 o F ��- �� t I , Section3 Township y2 North, Range(O est
Flood Plain: Zone District: Pia- , Total Acreage: 1.Q.117 , Overlay District:
Geological Hazard: , Airport Overlay District:
FEE OWNER(S)OF THE PROPERTY:
Name: So0( ILartSiTC--) lTy\ter--
Work Phone# Home Phone#(170-30-3(0/4, Email Address:
Address: (L( L--DCYL a 3
City/State/Zip Code 1.2‘vxd. 0 kr CC) eO-S-��
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:
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EXHIBIT
I (We) hereby depose and state under penalties of perjury that all statements, proposals, and i
with or contained within the application are true and correct to the best of my (our)knowledge
owners of property must sign this application. If an Authorized Agent signs, a letter of author
owners must be included with the application. If a corporation is the fee owner, notarized evi
indicating that the signajory has to legal authority to sign for the corporations f
Signature: Owner or Authorized Agent Date Signature: Owner or Authorized Agent Date
2007-0779
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.
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2. Explain how this proposal is consi ent wi th intent of the Weld County Code, Chapter 22
(Comprehensive Plan). T-.t C� F� ck, tac_ aryl ('tIu:� U3t LLAL.Q
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3. Explain how this proposal is consifftent with the intent of tht Weld County Code, Chapter 23 (Zoning) and
the zone district in which it is located.
4. What type of uses surround the site? Explain how the proposed use is consistent and compatible with
surrounding land uses. ft y.rvtjs� (S, k-t— i W-h-tcJL— G ( �1
5. Describe, in detail, the following: CJ O r\ Ot r-—
a. How many people will use this site?
b. How many employees a proposed to bee toyed at this site?
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c. What are the hours of operation.
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d. What type and how many str cures will be erected tbuilt) on this ite? .
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e. What tyke and how1,�many animal if any, will be or this site?
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f. What kind (t9jpe,,,size,{ weight)of hicles will access this sit and how often?
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g. Who will,orovide fire protection to the site? U
h. What is the water source on the property.. (T Both domestic and irrigation).
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(What is the sewag disposal system on the property? (Existing and p posed).
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j. storage or w r ht5using propose what type of items will be stored?
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6. Explain the proposed landscaping for the site. The landscaping shall be separately submitted as a
landscape plan map as part of th application submittal. 1l t) �t G Coi ct_c ((_i.,1,(S e per^//l Q
of LrJ-Y'
7. Explain any proposed reclamation procedures when termination of the Use by Special Review activity
occurs.
8. Explain how the storm water
drainage will be handled on the site.
9. Explain how long 4#'will take to construct this site and when construction and landscaping is scheduled to
begin. orecdtj, 1_ . '04t--
10. Explain where storage and/or stockpile of wastes will occur on this site.
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FOR COMMERCIAL SITES, PLEASE COMPLETE THE FOLLOWING INFORMATION
BUSINESS EMERGENCY INFORMATION:
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BusinessNaam•�dt J iM l'( Ih� • Phone: 01-70 Oa 13(/
Address: 4)(J (4 '��L vZ j City, ST, Zip: L-21 44\A--017-`St✓' CD t0S5t
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Business Owner: aL-vtS - � �OCA 5JQLr' Phone: et�O^U Ica —c3✓7
Home Address: & City, ST, Zip: (Si nA r- (-O 0S50
List three persons in the order to be called in the event of an emergency:
NAME TITLE
E,,^ 2-10\ ADDRESS PHONE
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Lj ncic� t�� 31`� Ec k520 Lig 3-g0`l7
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Business Hours: flext"--- fYpri,- Days: µ6n- 51�r-. .
Type of Alarm: one Burglar Holdup Fire Silent Audible
Name and address of Alarm Company:
Location of Safe:
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MISCELLANEOUS INFORMATION:
Number of entry/exit doors in this building: r� Location(s): J) d ( d bO". On (7 ad—
oeF bucodine doote- to bock— l( n& joln bo-n
Is alcohol stored in building? to Location(s):
:
Are drugs stored in building? At Location(s):
' W Are weapons stored in building? 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: h V
Main Electrical: L)OOG( pole - ocU c rr -�- 1(04 . QYt�e`��Sfin q_' 46i `off--
Gas Shut Off: Qh C- C a3
Exterior Water Shutoff: b f1 Lit d-5
Interior Water Shutoff:
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