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Home My WebLink About20020438.tiff Or, ,v`a DEPARTMENT OF PLANNING SERVICES 1555 N. 17th Avenue, Greeley, CO 80631 Phone (970) 353-6100, Ext. 3540, Fax (970)304-6498 USE BY SPECIAL REVIEW APPLICATION Application Fee Paid Receipt# Date Recording Fee Paid Receipt# Date Application Reviewed by: TO BE COMPLETED BY APPLICANT: (Please print or type, except for necessary signature) LEGAL DESCRIPTION OF SPECIAL REVIEW PERMIT AREA: 11 l )('.f1c Ic, 4=h IVY PARCEL NUMBER: 4 L ELL 3 3 (12 digit number-found on Tax I.D. Information or obtained at the Assessor's Office. / Section 91. , T N, R W-Total Acreages Zone District 6 Overlay Zone Property Address Of available) /5-7`/ N )9+1 '`}/(e_ ( ✓ � 7r E 3/ Proposed Use eck� c-j CL> \ ti 4 -!(.ac) h: r, SURFACE FEE (PROPERTY OWNERS) OF AREA PROPOSED FOR THE SPECIAL REVIEW 7 PERMIT Name: 1- /v •1 4rr' Address: )r//C 9u /Sel'f- 5{-le 31 3 (`;X.) City/State/Zip: 4; ;.,,. (E// le' Home Telephon�. %f>G77), Business Telephone Si-V-O 72 // Name: lr7 /) rAJ4f..' (41/76>/c, Address: '3 ;1) /)/(LC-1. it/ /, �(c �5-)� ) City/State/Zip:62.x.. '506't Herne Telephone: WSJ>-E 23 5 Business Telephor;3 3S-1-C%2 APPLICANT OR AUTHORIZED AGENT (if different than above) Name: 7r�i� // ,h1' )t Address: /S7 2 k • . 9444/91./<1 City/State/Zip: / „ 3/ Home Telephoner%70 Business Telephone: S,9-z' 1 c_ DEPARTMENT OF PLANNING SERVICES USE ONLY Case# Floodplain: o Yes 0 No Geologic Hazard: 0 Yes 0 No I hereby state that all statements and plans submitted with the application are true and correct to the best of my knowledge. Rev: 1-4-01 EXHIBIT n ure: n r o Aut anzed n> 5 2002-0438 FOR COMMERCIAL SITES, PLEASE FILL OUT THE FOLLOWING INFORMATION ..BUSINESS EMERGENCY INFORMATION: Business Name: Lo c\c ;\o. Phone: (CO O'54b-17 b3 Address: 1,S 1'� N ai .s 4 h PN e 6✓ -L -t ) j (2c-, 'O6 ?/ Business Owner: i�F'(\erc c1Q ('Acu i_Phone: (g1O"i 34L" ?7L$ Home Address: \Sri N as+v, Ave City:Q'yfeElF�� List three persons in the order to be called in the event of an emergency: NAME TITLE ADDRESS PHONE jngYLAck Mon(G0( ( cnJt4Q CI 51 � OSA k\tk C.1 - (9 701 3:6 -9o3 nSe L_. Mc,aquo ( OA iHt� `!a N eS\v, t�U� Roan,o„, A ekkrc\vet I3nn ) 113 6+N ►'\Vt lc11D) 31 I - 1k-�10 Business Hours: 7ck,m - 5 P;m Days: tc onac\\j - cx1 - Type of Alarm: None Burglar Holdup Fire Silent Audible Name and address of alarm company: „Location of Safe: 'ant. p(\ky *************************************************************************************************************#********#*#* MISCELLANEOUS INFORMATION: Number of entry/exit doors in this building: Location(s): WES\ I SO O h Is alcohol stored in building? W.) Location(s): ban-4 WC3t € OJ11l Are drugs stored in building?_HO Location(s): Are weapons stored in building? 1`1 O Location(s): The following programs are offered as a public service of the Weld County Sheriff's Office. Please indicate the programs of interest. Physical security check Crime Prevention Presentation UTILITY SHUT OFF LOCATIONS: Main electrical: AO \hQ riQS} coca\€' (1-c -A vIc S\C,{1? Gas shut off: . (\(kyO.fc{, heh.ad aY'e hO��e Exterior water shutoff: pp.cf k mnr('k Interior water shutoff: t(J ( C\OS2} 6 Special review Questionnaire/Answers #1 The kicthen we want to open is for carry out food only. Their will be no chairs nor tables for customers to stay an eat their food on this location. Food will be made on a dayly bases not more then 12 hours in advance. their will be one special item of the day. We will not be deep frying any food in this kicthen. We will not be hiring any out side help, it will be family operated only. The kicthen is located in side the little store called(La Tiendita) Thank you ! #2 (yes) #3 (Yes) #4 single family residential. A) (2) as in my husband an myself some times my kids well come help us. B) 2-5 C) 6:00 A:M 6:00P.MTuesday-Saturday these hour may vary on holidays. D) none E) none F) none G) union colony fire rescue H) City OF Greeley I) City Of Greeley J) none #6) none will stay the same #7) none #8) City Of Greeley #9) no construction is going to be added to this building. # 10) None will occur. (71 � 1.7 � � � APPENDIX B WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Public Works Department Date: ///r/at 1111 H Street,P.O. Box 758, Greeley,CO 80632 Phone: (970)356-4000,Ext. 3750 Fax: (970)304-6497 y7 1. Applicant Name �� r n t rei i // Fi U€7 Phone(9'a) 3 A4---a>cle Address 1TG% At Jt /7ri`F City rf f a v Staters Zip Rear/ 2. Address or location of access /57) 14 a-S illdf, Orr fl:9/ 12, id5X Section 36 Township 6 Range 6 6 Subdivision Block Lot // Weld County-RBI # e2St'ipol Side of Road L+.) Distance from nearest intersection /So 741. 3. Is there an existing access to the property? Yes )C No #of accesses 4. Proposed Use: ❑ Permanent ❑ Residential/Agricultural ❑ Industrial:ITemporary ❑ Subdivision ❑ Commercial g Other ("Any so-I #id..v,, 5. Site Sketch LW Aw .. Legend for Access Description: 7b AG = Agricultural ••,' .:,-, a.K r ,-RES = Residential _ kG= Oil&Gas D.R. = Ditch Road vi f ; I______ ********************************** 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: 8 9 /577 k • _29 t"-52—c E/7._ ,,-^ ZI 1 ,,, - tie...NH.' I q. j 0 ii IMe -.j I t 1 1.} `fir! lc �, r ft r„ r : , ,� s _ CT- : H , 1 ' '�i l ., i E '.- '� s .v Pi -. „ill is- ti", ."414 , ..› Cz a V \\ X11O O 7 9 IS N. 41 i-X1 1 \J r .Q J l 1 • - 1 j I. S',1 ‘.\4 (2'1'":"1-- ii::)\� ��. sue.. --� ?_ w J b 'J. -- I ilift r f,-. f ;._ it,ie '• , , ' ,. %•,, , ii_. ..._ _ , , , ,_ I ii , ,.._. , i ..... .,. ,• , _______ . 'I 1 ''. / ' . • i I . „ . 1 i , . , N., , , , . i , i I p, I il iI I i \ --t , , ,,,: , I r i i I , i LI , \ 1 i‘ I . 1 a Ili f { ) , ; !, 44+1 \- ....-L. • •ll 1i f I . ' I ! 1 \,._, I ._ IL I I i "...... 1,. \ ....1 ill 1 . ,fie I .JJjJ.• � � 1 All : 1 : 1 ;�� il."'‘ i C Cw-r = o .- . P� > W L oaSI ts.- E., in wpm 8 C Sy:-wi-2 c, 3rJ .O ' oNFc ct , g U 6 � 4' `` c063 E .�« .j D� ' . 5 +,N « a-mama m 4O et r E 0-: N E'er • ,;2 C 0013.0'5 O s'At `R•'Yk ° Yo "A •{ A"nom 7'Q w 4 zQo- Qu � z i -1 O M . J a p , Q .QL — v `p „ T rp,gtii J�� ,cc cc Q O as N itqq �OiO n u o V z N + Zm o 3 rpr-�zEI , , .7.-...,,,,2 Q Z� C a rt. p ' k x 2 CC oo '0 - a� W f ms's"1- LLI v a v 0 ,w Ix d Q o c _I d ae x �,.t, < ° W♦) W re W.<=k, B ,k� w a x 1 m 0 1� #} J N CJ ao-t x i. 8 'D© w 8 ,,per W , , a J ro a ul P,° I- Q ^ DEPARTMENT OFF LIC HEALTH AND ENVIRONMENT 1555 N. 17TH AVENUE lial; GREELEY,COLORADO 80631 ADMINISTRATION(970)304-6410 PUBLIC HEALTH EDUCATION AND NURSING(970)304-6420 wipe FES(970)304-6415 ENVIRONMENTAL HEALTH SERVICES(970)304-6415 FAX(970)304-6411 COLORADO Local Fire Department Approval for Weld County Food Service Establishments Date: 7/1 Establishment Name: 1,0 // Establishment Address: /> / ) �w City: I)A'-7 o�-y State: (Pt) Zip: 0(,.✓ Phone Number: (9A `(/6 4.76,. Tax I.D. Number: Seating Capacity: -- heck one of the following: The above named establishment meets the requirements for Fire Department approval. [ The above named establishment does not meet the requirements for Fire Department approval. [ Comments: "Jo (T-fl.?,NL -rind Pk000c e 5 /-,ee rsr 1 kDni 49ax S Local Jurisdiction: t cAz ;� b Fire Department Inspector Name (n mase print): /all �uw.rRn-t �/ �� Signature of Inspector: 95V-- Fire Department Inspector Title: no,. CC,,,e,s7 Phone Number: (%7u ) 35D 7S Please Remit to: Weld County Department of Public Health and Environment Attn: Environmental Health Services 1555 North 17th Avenue Greeley, Colorado 80631 Phone No.: (970) 304-6415 Fax: (970) 304-6411 WELD COUNTY DEPARTMENT OF PUBLIC HEALTH&ENVIRONMENT ENVIRONMENTAL HEALTH 1555 N. 17Th AVENUE GREELEY,CO 80631 (970)304-6415 T DATE: 9-t/ of RECEIVED OF le li e-A"_olA tCA ADDRESS AMOUNT ©� 7S DOLLARS 100 PAID IN FULL ON ACCOUNT 14014- 06-2 ti a26Cc G CASH CHECK MONEY � ORDER- pl ^C. [/3.2'GCr FOR e. 6500) RECEIPT NUMBER N! 02396 RECEIVED BY:�r 19-4170-212 ,.� Alvin V.Garcia 1410 38th Avenue Greeley CO, 80634 October 4,2001 To Whom It May Concern: I the owner of 1517 N. 25`h Avenue Greeley Colorado hereby acknowledge and give permission for the construction and opening of the kitchen in the above-mentioned property. Should you need to contact me for further information and or approval please feel free to call me at the following numbers 353-6733 or 506-9476. Regards, Alvin V. Garcia STATE OF COLORADO COUNTY OF WELD Subscribed and sworn to before me by ALVIN V. GARCIA this 4th day of October, 2001. '1/4pAY PUS ./ .t ''• %Veill Helene Rasmusse , Notary Public HEIENE My commission expires July 28, 2003 i `• RASMUSSEN i IIl,TF ....OF .. OF Mi Hello