HomeMy WebLinkAbout20193938.tiffBEFORE THE WELD COUNTY. COLORADO. PLANNING COMMISSION
RESOLUTION OF RECOMMENDATION TO THE BOARD OF COUNTY COMMISSIONERS
Moved by Gene Stifle, that the following resolution be introduced for passage by the Weld County Planning
Commission. Be it resolved by the Weld County Planning Commission that the application for:
CASE NUMBER:
APPLICANT
PLANNER:
REQUEST
LEGAL DESCRIPTION
LOCATION:
USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
MAXWELL NADER
A SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL REVIEW
PERMIT FOR A HOME BUSINESS (TRANSMISSION REPAIR SHOP) AND ONE
(1) SINGLE-FAMILY DWELLING UNIT PER LOT OTHER THAN THOSE
PERMITTED UNDER SECTION 23-3-20.A. (SECOND SINGLE-FAMILY
DWELLING UNIT) IN THE A (AGRICULTURAL) ZONE DISTRICT
LOT B REC EXEMPT RE -2820, PART N2NE4 SECTION 8. T4N. R64W OF THE
6TH P.M.. WELD COUNTY. COLORADO.
SOUTH OF AND ADJACENT TO CR 48; APPROXIMATELY 500 FEET WEST OF
CR 53.
be recommended favorably to the Board of County Commissioners for the following reasons:
1. The submitted materials are in compliance with the application requirements of Section 23-2-260 of
the Weld County Code.
2. It is the opinion of the Planning Commission that the applicant has shown compliance with Section 23-
2-220 of the Weld County Code as follows:
A. Section 23-2-220.A.1 -- The proposed use is consistent with Chapter 22 and any other
applicable code provisions or ordinance in effect.
Section 22-2-20.F.2 - A.Policy 6.2. States, "Support opportunities. such as but not limited to
hobby farming and home businesses. to supplement family income and reduce living
expenses for farm families and others who prefer a rural lifestyle.
Section 22-2-20. G. - A.Policy 7.2. Conversion of agricultural land to nonurban residential,
commercial and industrial uses should be accommodated when the subject site is in an area
that can support such development, and should attempt to be compatible with the region.
The business is compatible because the use will primarily be within the accessory structure
being the pole barn. The application materials state that this transmission shop will primarily
be for the surrounding farmers and neighbor's equipment in the area.
Section 22-2-20. H. - A. Goal 8. States. "Ensure that adequate services and facilities are
currently available or reasonably obtainable to accommodate the requested new land use
change for more intensive development."
There is currently water and septic service provided to the property. The house on the
property is currently served by Central Weld County Water District (CWCWD) via Tap # 1794.
Water for the business and second home is available through Central Weld County Water
District via a letter from CWCWD dated April 25, 2019. A septic permit (SP -0100193) sized
for three (3) bedrooms was issued May 29. 2001 for the current home on the property. A new
on -Site Wastewater Treatment System (OWTS) will serve the business and the second
dwelling.
Section 23-2-220.A.2 -- The proposed use is consistent with the intent of the A (Agricultural)
Zone District.
Section 23-3-10. -- Intent. of the Weld County Code states. "The A (Agricultural) Zone District
is also intended to provide areas for the conduct of Uses by Special Review which have been
determined to be more intense or to have a potentially greater impact than Uses Allowed by
Right." This code section allows the applicant to apply for a USR (Use by Special Review)
Permit.
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 2
Section 23-3-40.M. -- Uses by special review, of the Weld County Code allows for "one (1)
single-family dwelling unit per lot other than those permitted under section 23-3-20.A. (second
single-family dwelling unit)" in the Agricultural (A) Zone District. This code section allows the
applicant to apply for the subject second home.
Section 23-3-40.P.-- Uses by special review, of the Weld County Code allows for a "home
business" in the Agricultural (A) Zone District. This code section allows the applicant to apply
for the home business.
C. Section 23-2-220.A.3 -- The uses which will be permitted will be compatible with the existing
surrounding land uses.
The subject property currently has an Oil and Gas Support Facility (USR-11447). This USR
will be fully vacated prior to recording of the new USR. There are several Use by Special
Review permits within one (1) mile of the subject property. Including one (1) accessory
structure, one (1) roping arena, one (1) airstrip, one (1) 400 head dairy, one (1) Oil and Gas
Support Service facility, two (2) in Ag related facilities, two (2) Mineral Resource Facility and
two (2) second single family residences.
The Weld County Department of Planning Services sent notice to ten (10) surrounding
property owners within five -hundred (500) feet. No correspondences were received back from
surrounding property owners regarding the proposed application. There were no mails or
phone calls received regarding the proposed application.
D. Section 23-2-220.A.4 -- The uses which will be permitted will be compatible with future
development of the surrounding area as permitted by the existing zoning and with the future
development as projected by Chapter 22 of the Weld County Code and any other applicable
code provisions or ordinances in effect, or the adopted Master Plans of affected
municipalities.
The site is located within the three (3) mile referral area of the Kersey. The Town of Kersey
did not return a referral. The site is also located within the Town of Kersey's Coordinated
Planning Agreement (CPA). The town indicated on the signed Notice of Inquiry form dated
May 14, 2019 that the property is not eligible for annexation and no further comments.
E. Section 23-2-220.A.5 -- The application complies with Chapter 23, Articles V and XI, of the
Weld County Code.
The property is not within the Geologic Hazard Overlay District, a Special Flood Hazard Area,
Airport Overlay District or the Municipal Separate Storm Sewer System (MS4) area.
Building Permits issued on the lot will be required to adhere to the fee structure of the
County -Wide Road Impact Fee, County Facility Fee and Drainage Impact Fee Programs.
F. Section 23-2-220.A.6 -- The applicant has demonstrated a diligent effort to conserve prime
agricultural land in the locational decision for the proposed use.
The soil designation for the site is "Irrigated (not prime) per the 1979 Soil Conservation
Service Important Farmlands of Weld County Map. The site is not being used for agricultural
production and the small lot size is not suitable for farming.
G. Section 23-2-220.A.7 — There is adequate provisions for the protection of the health, safety,
and welfare of the inhabitants of the neighborhood and County.
The Design Standards (Section 23-2-240, Weld County Code), Operation Standards (Section
23-2-250, Weld County Code), Conditions of Approval and Development Standards can
ensure that there are adequate provisions for the protection of health, safety, and welfare of
the inhabitants of the neighborhood and County.
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 3
This recommendation is based, in part, upon a review of the application materials submitted by the applicant,
other relevant information regarding the request, and responses from referral entities.
The Planning Commission recommendation for approval is conditional upon the following:
1. Prior to recording the map:
A. A final drainage report or qualifying narrative is required prior to recording the USR map.
(Department of Public Works)
B. USR-1447 shall be vacated prior to recording the USR map. (Department of Planning Services)
C. The applicant shall attempt to address the requirements of the Platte Valley Fire Protection
District, as stated in the referral response dated May 15, 2019. Written evidence of such shall
be submitted to the Weld County Department of Planning Services. (Department of Planning
Services)
D. The plat shall be amended to delineate the following:
1. All sheets of the map shall be labeled USR19-0039 (Department of Planning Services)
2. The attached Development Standards. (Department of Planning Services)
3. The map shall be prepared in accordance with Section 23-2-260.D of the Weld County
Code. (Department of Planning Services)
4. All signs shall be shown on the map and shall adhere to Chapter 23, Article IV, Division 2
and Appendices 23-C, 23-D and 23-E of the Weld County Code. (Department of Planning
Services)
5. The map shall delineate the parking area for the employees. (Department of Planning
Services)
6. County Road 48 is a gravel road and is designated on the Weld County Functional
Classification Map as a local road which requires 60 feet of right-of-way at full buildout.
The applicant shall delineate and label on the site map or plat the future and existing
right-of-way (along with the documents creating the existing right-of-way) and the
physical location of the road. All setbacks shall be measured from the edge of right-of-
way. This road is maintained by Weld County. (Department of Public Works)
7. Show and label the approved access locations, approved access width and the
appropriate turning radii (60') on the site plan. The applicant must obtain an access
permit in the approved location(s) prior to construction. (Department of Public Works)
8. Show and label the entrance gate if applicable. An access approach that is gated shall
be designed so that the longest vehicle (including trailers) using the access can
completely clear the traveled way when the gate is closed. In no event, shall the distance
from the gate to the edge of the traveled surface be less than 35 feet. (Department of
Public Works)
9. Show and label the drainage flow arrows. (Department of Public Works)
10. Show and label the parking and traffic circulation flow arrows showing how the traffic
moves around the property. (Department of Public Works)
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 4
2. Upon completion of Condition of Approval #1 above, the applicant shall submit one (1) electronic copy
(.pdf) of the map for preliminary approval to the Weld County Department of Planning Services. Upon
approval of the map the applicant shall submit a Mylar map along with all other documentation
required as Conditions of Approval. The Mylar map shall be recorded in the office of the Weld County
Clerk and Recorder by the Department of Planning Services. The map shall be prepared in
accordance with the requirements of Section 23-2-260.D of the Weld County Code. The Mylar map
and additional requirements shall be submitted within one hundred twenty (120) days from the date of
the Board of County Commissioners Resolution. The applicant shall be responsible for paying the
recording fee. (Department of Planning Services)
3. In accordance with Weld County Code Ordinance #2012-3, approved April 30, 2012, should the plat
not be recorded within the required one hundred twenty (120) days from the date of the Board of
County Commissioners Resolution, a $50.00 recording continuance charge shall be added for each
additional three (3) month period. (Department of Planning Services)
4. Prior to Construction:
A. The approved access and tracking control shall be constructed prior to on -site construction.
(Department of Public Works)
5. Prior to the issuance of the Certificate of Occupancy:
A. An On -Site Wastewater Treatment System (OWTS) is required and shall be installed according to
the Weld County On -site Waste -water Treatment System Regulations. The OWTS is required to
be designed by a Colorado Registered Professional Engineer according to the Weld County
OWTS Regulations. (Department of Public Health and Environment)
6. The Use by Special Review Permit is not perfected until the Conditions of Approval are completed
and the map is recorded. Activity shall not occur, nor shall any building or electrical permits be issued
on the property, until the Use by Special Review plat is ready to be recorded in the office of the Weld
County Clerk and Recorder or the applicant has been approved for an early release agreement
(Department of Planning Services)
Motion seconded by Elijah Hatch.
VOTE:
For Passage
Bruce Johnson
Michael Wailes
Tom Cope
Gene Stille
Lonnie Ford
Richard Beck
Elijah Hatch
Skip Holland
Against Passage Absent
The Chair declared the resolution passed and ordered that a certified copy be forwarded with the file of this
case to the Board of County Commissioner's for further proceedings.
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 5
CERTIFICATION OF COPY
I, Kristine Ranslem, Recording Secretary for the Weld County Planning Commission, do hereby certify that the
above and foregoing resolution is a true copy of the resolution of the Planning Commission of Weld County,
Colorado, adopted on August 20, 2019.
Dated the 20'" of August, 2019
Kristine Ranslem
Secretary
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 6
SITE SPECIFIC DEVELOPMENT PLAN
USE BY SPECIAL REVIEW PERMIT
DEVELOPMENT STANDARDS
Apryl L. and Manuel Gallegos -Herrera
USR19-0039
1. A Site Specific Development Plan and Use by Special Review Permit, USR19-0039, for a Home Business
(transmission repair shop) and one (1) single-family dwelling unit per lot other than those permitted under
Section 23-3-20.A. (second single-family dwelling unit) in the A (Agricultural) Zone District, subject to the
Development Standards stated hereon. (Department of Planning Services)
2. Approval of this plan may create a vested property right pursuant to Section 23-8-10 of the Weld County
Code. (Department of Planning Services)
3. The hours of operation of the home business are 8:00 a.m. - 5:00 p.m. Monday — Friday and 8:00 a.m. -
12:00 p.m. Saturday, as requested in the application materials. (Department of Planning Services)
4. The number of on -site employees shall be four (4). (Department of Planning Services)
5. The parking area on the site shall be maintained. (Department of Planning Services)
6. All signs shall adhere to Chapter 23, Article IV, Division 2 and Appendices 23-C, 23-D and 23-E of the
Weld County Code. (Department of Planning Services)
7. Sources of light shall be shielded so that light rays will not shine directly onto adjacent properties where
such would cause a nuisance or interfere with the use on the adjacent properties in accordance with the
plan. Neither the direct, nor reflected, light from any light source may create a traffic hazard to operators
of motor vehicles on public or private streets. No colored lights may be used which may be confused with,
or construed as, traffic control devices. (Department of Planning Services)
8. All liquid and solid wastes (as defined in the Solid Wastes Disposal Sites and Facilities Act, 30 20 100.5,
C.R.S.) shall be stored and removed for final disposal in a manner that protects against surface and
groundwater contamination. (Department of Public Health and Environment)
9. No permanent disposal of wastes shall be permitted at this site. This is not meant to include those wastes
specifically excluded from the definition of a solid waste in the Solid Wastes Disposal Sites and Facilities
Act, 30-20-100.5, C.R.S. (Department of Public Health and Environment)
10. Waste materials shall be handled, stored, and disposed in a manner that controls fugitive dust, fugitive
particulate emissions, blowing debris, and other potential nuisance conditions. The applicant shall operate
in accordance with Chapter 14, Article 1 of the Weld County Code. (Department of Public Health and
Environment)
11. Fugitive dust should attempt to be confined on the property. Uses on the property should comply with the
Colorado Air Quality Commission's air quality regulations. (Department of Public Health and Environment)
12. All potentially hazardous chemicals must be handled in a safe manner in accordance with product
labeling. and in a manner, that minimizes the release of hazardous air pollutants (HAPs) and volatile
organic compounds (VOCs). All chemicals must be stored securely, on an impervious surface, and in
accordance with manufacturers' recommendations. (Department of Public Health and Environment)
13. The facility shall adhere to the maximum permissible noise levels allowed in the Residential Zone as
delineated in 25-12-103 C.R.S. (Department of Public Health and Environment)
14. Adequate drinking, hand washing, and toilet facilities shall be provided for employees and patrons, at all
times. (Department of Public Health and Environment)
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 7
15. A permanent, adequate water supply shall be provided for drinking and sanitary purposes. (Department of
Public Health and Environment)
16. Any septic system located on the property must comply with all provisions of the Weld County Code,
pertaining to On -site Wastewater Treatment Systems. (Department of Public Health and Environment)
17. The operation shall comply with all applicable rules and regulations of State and Federal agencies and the
Weld County Code. (Department of Public Health and Environment)
18. The operation shall comply with all applicable rules and regulations of State and Federal agencies and the
Weld County Code. (Department of Public Health and Environment)
19. The property owner or operator shall be responsible for controlling noxious weeds on the site, pursuant to
Chapter 15, Article I and II, of the Weld County Code. (Department of Public Works)
20. The access to the site shall be maintained to mitigate any impacts to the public road, including damages
and/or off -site tracking. (Department of Public Works)
21. There shall be no parking or staging of vehicles on public roads. On -site parking shall be utilized.
(Department of Public Works)
22. Any work that may occupy and or encroach upon any County rights -of -way or easement shall acquire an
approved Right -of -Way Use Permit prior to commencement. (Department of Public Works)
23. The historical flow patterns and runoff amounts on the site will be maintained. (Department of Public
Works)
24. Weld County is not responsible for the maintenance of onsite drainage related features. (Department of
Public Works)
25. Building permits may be required, per Section 29-3-10 of the Weld County Code. Currently, the following
have been adopted by Weld County: 2018 International Codes, 2006 International Energy Code, and 2017
National Electrical Code. A Building Permit Application must be completed and two (2) complete sets of
engineered plans bearing the wet stamp of a Colorado registered architect or engineer must be submitted
for review. A Geotechnical Engineering Report performed by a Colorado registered engineer shall be
required or an Open Hole Inspection. (Department of Building Inspection)
26. The Use by Special Review area shall be limited to the plans shown hereon and governed by the
foregoing standards and all applicable Weld County regulations. Substantial changes from the plans or
Development Standards, as shown or stated, shall require the approval of an amendment of the Permit by
the Weld County Board of County Commissioners before such changes from the plans or Development
Standards are permitted. Any other changes shall be filed in the office of the Department of Planning
Services.
27. The property owner or operator shall be responsible for complying with all of the foregoing Development
Standards. Noncompliance with any of the foregoing Development Standards may be reason for
revocation of the Permit by the Board of County Commissioners.
28. RIGHT TO EXTRACT MINERAL RESOURCES STATEMENT: Weld County has some of the most
abundant mineral resources, including, but not limited to, sand and gravel, oil, natural gas, and coal.
Under title 34 of the Colorado Revised Statutes, minerals are vital resources because (a) the state's
commercial mineral deposits are essential to the state's economy; (b) the populous counties of the state
face a critical shortage of such deposits; and (c) such deposits should be extracted according to a rational
plan, calculated to avoid waste of such deposits and cause the least practicable disruption of the ecology
and quality of life of the citizens of the populous counties of the state.
Mineral resource locations are widespread throughout the County and person moving into these areas
must recognize the various impacts associated with this development. Often times, mineral resource sites
RESOLUTION USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
PAGE 8
are fixed to their geographical and geophysical locations. Moreover, these resources are protected
property rights and mineral owners should be afforded the opportunity to extract the mineral resource.
29. WELD COUNTY'S RIGHT TO FARM STATEMENT: Weld County is one of the most productive
agricultural counties in the United States, typically ranking in the top ten counties in the country in total
market value of agricultural products sold. The rural areas of Weld County may be open and spacious,
but they are intensively used for agriculture. Persons moving into a rural area must recognize and accept
there are drawbacks, including conflicts with long-standing agricultural practices and a lower level of
services than in town. Along with the drawbacks come the incentives which attract urban dwellers to
relocate to rural areas: open views, spaciousness, wildlife, lack of city noise and congestion, and the rural
atmosphere and way of life. Without neighboring farms, those features which attract urban dwellers to
rural Weld County would quickly be gone forever.
Agricultural users of the land should not be expected to change their long-established agricultural
practices to accommodate the intrusions of urban users into a rural area. Well -run agricultural activities
will generate off -site impacts, including noise from tractors and equipment; slow -moving farm vehicles on
rural roads; dust from animal pens, field work, harvest and gravel roads; odor from animal confinement,
silage and manure; smoke from ditch burning; flies and mosquitoes; hunting and trapping activities;
shooting sports, legal hazing of nuisance wildlife; and the use of pesticides and fertilizers in the fields,
including the use of aerial spraying. It is common practice for agricultural producers to utilize an
accumulation of agricultural machinery and supplies to assist in their agricultural operations. A
concentration of miscellaneous agricultural materials often produces a visual disparity between rural and
urban areas of the County. Section 35-3.5-102, C.R.S., provides that an agricultural operation shall not be
found to be a public or private nuisance if the agricultural operation alleged to be a nuisance employs
methods or practices that are commonly or reasonably associated with agricultural production.
Water has been, and continues to be, the lifeline for the agricultural community. It is unrealistic to assume
that ditches and reservoirs may simply be moved "out of the way" of residential development. When
moving to the County, property owners and residents must realize they cannot take water from irrigation
ditches, lakes, or other structures, unless they have an adjudicated right to the water.
Weld County covers a land area of approximately four thousand (4,000) square miles in size (twice the
size of the State of Delaware) with more than three thousand seven hundred (3,700) miles of state and
county roads outside of municipalities. The sheer magnitude of the area to be served stretches available
resources. Law enforcement is based on responses to complaints more than on patrols of the County,
and the distances which must be traveled may delay all emergency responses, including law enforcement,
ambulance, and fire. Fire protection is usually provided by volunteers who must leave their jobs and
families to respond to emergencies. County gravel roads, no matter how often they are bladed, will not
provide the same kind of surface expected from a paved road. Snow removal priorities mean that roads
from subdivisions to arterials may not be cleared for several days after a major snowstorm. Services in
rural areas, in many cases, will not be equivalent to municipal services. Rural dwellers must, by
necessity, be more self-sufficient than urban dwellers.
People are exposed to different hazards in the County than in an urban or suburban setting. Farm
equipment and oil field equipment, ponds and irrigation ditches, electrical power for pumps and center
pivot operations, high speed traffic, sandburs, puncture vines, territorial farm dogs and livestock, and open
burning present real threats. Controlling children's activities is important, not only for their safety, but also
for the protection of the farmer's livelihood.
FL Min ups
SJ'o Izoici
SUMMARY OF THE WELD COUNTY PLANNING COMMISSION MEETING
Tuesday, August 20, 2019
A regular meeting of the Weld County Planning Commission was held in the Weld County Administration
Building, Hearing Room, 1150 O Street, Greeley, Colorado. This meeting was called to order by Chair,
Michael Wailes. at 12:30 pm.
Roll Call.
Present: Michael Wailes. Gene Stille. Tom Cope. Lonnie Ford. Richard Beck, Elijah Hatch, Skip Holland.
Absent: Bruce Johnson.
Also Present: Kim Ogle. Chris Gathman. Diana Aungst. Maxwell Nader, and Tom Parko, Department of
Planning Services: Lauren Light. Department of Health: Evan Pinkham, Hayley Balzano, Zackery Roberson
and Mike McRoberts, Public Works; Bruce Barker and Kahn McDougal, County Attorney. and Kris Ranslem,
Secretary.
CASE NUMBER:
APPLICANT
PLANNER
REQUEST
LEGAL DESCRIPTION
LOCATION
USR19-0039
MANUEL GALLEGOS-HERRERA AND APRYL HERRERA
MAXWELL NADER
A SITE SPECIFIC DEVELOPMENT PLAN AND USE BY SPECIAL REVIEW
PERMIT FOR A HOME BUSINESS (TRANSMISSION REPAIR SHOP) AND ONE
(1) SINGLE-FAMILY DWELLING UNIT PER LOT OTHER THAN THOSE
PERMITTED UNDER SECTION 23-3-20.A. (SECOND SINGLE-FAMILY
DWELLING UNIT) IN THE A (AGRICULTURAL) ZONE DISTRICT
LOT B REC EXEMPT RE -2820, PART N2NE4 SECTION 8, T4N. R64W OF THE
6TH P.M.. WELD COUNTY. COLORADO.
SOUTH OF AND ADJACENT TO CR 48; APPROXIMATELY 500 FEET WEST OF
CR 53.
Maxwell Nader, Planning Services, presented Case USR19-0039, reading the recommendation and
comments into the record. The Department of Planning Services recommends approval of this application
with the attached conditions of approval and development standards.
(Bruce Johnson entered the hearing at 12:58 pm)
Zackery Roberson. Public Works. reported on the existing traffic. access to the site and drainage conditions
for the site.
Lauren Light, Environmental Health. reviewed the public water and sanitary sewer requirements. on -site
dust control, and the Waste Handling Plan.
Manuel Herrera. 25868 CR 48. Kersey. Colorado, stated that the second dwelling will be for his parents.
Commissioner Cope asked where the oils will be disposed of. Mr. Herrera said that they have storage of
the oil and then they have a company that will pick up the oil.
In response to Commissioner Stille's inquiry of the second home, Mr. Herrera said that the second home
will be a manufactured home on foundation.
The Chair asked if there was anyone in the audience who wished to speak for or against this application.
No one wished to speak.
The Chair asked the applicant if they have read through the Development Standards and Conditions of
Approval and if they are in agreement with those. The applicant replied that they are in agreement.
Motion: Forward Case USR19-0039 to the Board of County Commissioners along with the Conditions of
Approval and Development Standards with the Planning Commission's recommendation of approval.
Moved by Gene Stille. Seconded by Elijah Hatch.
1.
Vote: Motion carried by unanimous roll call vote (summary: Yes = 8).
Yes: Bruce Johnson, Elijah Hatch. Gene Stille, Lonnie Ford. Michael Wailes, Richard Beck, Skip Holland,
Tom Cope.
Meeting adjourned at 6:08 pm.
Respectfully submitted,
46thd/11-- ?Miadie.J;t1._
Kristine Ranslem
Secretary
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ATTENDANCE RECORD
NAME - PLEASE PRINT LEGIBLY
ADDRESS
EMAIL
John Doe
123 Nowhere Street, City, State, Zip
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