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HomeMy WebLinkAboutbocc.con.013.1983 � \: .�t.' ' I �:J::�. `� � n�A�"�,r. �t�,� y� �.: }y t .�`x �5 �x��,� 1 �' yi :yf r� �:..� FrN s'�"�wdr1_ . ,� �x f{,n 7r '� t�� ''k' ♦{.�l"E�r;�' > F 7' � � `� r`�L � .l� ' +t � � � ��^r�S.'�Qr�s��r+4 L� r ���rf S ,k r .ti �,if�`jJ� v6'r�. ,({� ti�1 . y�i-�{,�.�� �"''�d: v.�., 1 r'� S. �}",j,� _ � t� ��...!s? f H �...�: '� ��(f �r' �,:: � °f�,�s y k�Y r.e�X'�a';h�.� � ��".�.,_3! ._� aa:i......tWw ,. .., .. . , .'i3 v� ��.:�������_ , :.;.c. �ti' . . i ;�E . ' , . . . � �`` � � � Al'PI,ICA'L'ION I�OR LICrNSr ' �.� :r: ;t�j � TO OPL•'lo1TE A1:BtILAPICG SI:RVICti IN � � :� ;,; �; PITKIN COUNT7, COLORARO �:. •. - {1�'�� CA 13(83) ' . � 1. SERVICC PIAtfIi ��F�EiJ �(Al.lbl 1�Sp�1iAL. AMl3v1.nrlc:�. � ., y 2. ADDRGSS O�a o CASrt� C.R�. !�. �sa�oJ � • �;, 3. PFIDNE NUI•iB�R q2.s'- 11Zc� . � Ej . !� 6. IIESCRIPTION OP EACiI ATtEULANCE to be operated by appYicant (include make, ° 5 model, year of manufacture, Colorado 5[ate li�ense number, motor vehicle '� �� � cnassis numbcr): ;.a, . t ,� ��}� FORta JAf� - MoDVUatz ��lZq `� G�u�N I" F���,,,'��� ;� _ E13�AIiEt-� 9atz � .?3'1 ;G� �OL7<.F Mh�n1 �API��,L�r �t CC]JNT4 .��IL�` . •� ; t$356 FSaXoc583� � _ t,.�" . :•g "rrsrt- �nncNnt_ �l�wa�i1ZU�i5, l4l0�.. • `F�JD '�fc�.lr.�rv 3�3" r� 5B SS 1'1�b •A :ry ' —_ `"�' S. LOCATIO:V AND DESCP.IFTIO� of pla�e or pl�ces from which the applic�nt's - n.:� . �� ambulance service operates: • ' u, - j;s. ; �=_. �2c o CRS"lE CR�.t� 1Zo A� /L P� :. ry 2 �'���� , . . L .'J.�;� , . �"�,' ' �� i �C: ..��.._ � . `.`, � r � 6. 'Piie undersigned, representing the applicant herein, certifies, wiEh respect � to the aa:bulance service for wbich this permit is sought (and vehicles 'a` y� to.be used by the applican� in providi.ng such service} that: � z,� 5:. . (a) Each ambu2ance listed �� 'n�,anagr�4 above has passed the Colorado �-`� motor vehi.cle 'Eiun wiChin the year precceding the date of this :,,� iun. � PSC K�,.brt�ut-TN�.r 1lni .BobJ a�6tsrt+n � _�'� �-. (b) Each ambulance listed in para�raph 4 above is covered by a complying }_ po�i�y as defined in �ection i0-4-703, C.R.S. 1973. �r� . �• _ ":� (c} E�ch ambulance listed ir. paragraph 4 above_will be sCaffeu by at least � %,� ' . .. two persons at every scene ef a call for medical assistance, and at �"., �- all times that a paCient is baing transported, a driver and an ?:�`•:;':;. '. L? attendant. .Eacli ambulance driver possesses a valid Colorado Driver's ��:''',. � �i � License ac�d c�irrent certificatica in either Aaerican Red Cross or - Americnn flc�rt Assoc?.atf.on CPP. A.dditionally, each driver holds c!�[rent ceiti[icat?on in, at minimum, either M�crican Red Cross , Advanced First Aid, CrasL Injacy hlanagement, �r Trc�uina D[�uagement, i ' &ZCh attend�nt is a currently certified Cmer�;ency l:edical Tecl�nician, or !� • An PN wLc+ __ adliticr,aliy �raineci and eer�iiLed in CrasL Injucy ! i ttanarement or Trauma 1lanngcmenL as described above. f (d) Each antbul:�nce lisCed in paca�;r.iph 4 above eontains equipuient wtiich ' mects or c�cceJs thc reqidreiuents set forth in the "Ambulance j ' Inspection Shcet." • � � i (c)� tiach ami�ulnnrc listed !n ��nraf�rnph 4 lbovic eha11 maintnii; two-way � r�dio comiuunlcatiou capahi2l[y wltlt che reccivin}; medical Encili[y. �,�,. y;�� ' , . . . . . . . . _ . . . . . i"-...• ,, � ,,,; , - „�:;�, � � _ � . sk ��c�1, y { - .f��. .�� -�u 4 � . ��,!'� r4.. ! � S+ �.y�y rr o� tt �av ry Ed� �'r �y'�,,y�'dt �'t } Fr ty V. tirw -��e . � � ''��F� f € }�Ft� t �s , ;,:� � �a ir ' �r Ys��,}�S�"x a'y� t � � � ���i— �y s ,aw� <p f4 .� . 7 S�'t3 �.0.�-*, ��'`�"�3 r.tr.M k} � �._�� 13 t e��'�. uy `�+ �,��.`1'+ ',F,,�..�,� � ��u y �f �". t '' ° . ��F -}���5 1�,�� �''l�r�'��� d} � ��t�'�y3�i � �'�,a. , _�' ['�t i 1��,.�+1'r �rr'.yt'�� r . . s.�.�YJ Z'. , i z'`���;n:r?�i:rc.cw.{.,zN.�r-���'�...m�ca���_i...r. .. -•lrtc� ._..,, i__e,..:,a,'_5...•��,H.vrn.:,+.a'r..w�ei.�,. - . 1' i. ' � � k . .. ' � ' - , � 'N7fi:: In thc evcnt th� :�ppLlcrint c:ceka ii wnlvcr [rom any nE tlic [c�reFolnF; ;,, ^� " :rc��ulrcu:enCa, pli•:ivc sL•al•e Llw nnturc'aE tfic r:pecifSc w:itvar rcnuc:ited, L•lic 1:i':: � nced tor c6c �mlvec, any alCcru�tc propns.ili�, :my pl.ut or commttmci�t �o mucl ` y"� thc r�quirnricnt�, nnd 1 �CaL'emen[ as to vhy, ii granted, tlic wnlvcr wi.11 uot i '' advcrscly aEfect thc puh2lc wclfarc: :an_.�,� . , . � . -.. ! . ' � . �� .:.� . y.t � • � • a� ,� . �`' , k _�J;:r r.•.f. ��,�.'�''�. ����. . . �'4� . . .�:�,...t� . 4 . . �,�"1-:. . . � �F:�- . . . . 1y,�-• Sr=t: � ���: . 6�;; � '� ��i. i ���: � y�.. /n�j�. ?;`: . Date dV/[�O�y �;'i ' Signature r� G���G���� Title �^;;� �i,,,:�' G?.ANT OF PERt1IT �:':`:,� ' � 4�� The undersigned, repreaenting the Board of County Commissioners oF Pitkin � ' �'°'' Count Colorado, does her�b rant a license to the above na��d a licant to � , x;.. Y. Y 8 PP "`%• iovide ambulance setvice within Pitkin CounC fi�� ...:j p y (and does.fu�ther isse� a permit �'� for each ambulance listed in paragraph 4 of this application to be used in i t _�-�,� providino such service}; bnrh of which license and perr.�it(s) shall be ��lid I * throu�h th� date of Decer,�ber 31, li3t�, Pron the date hereof (unless earlier � ''�+ revoked by the Board of County Commissioners pursuant to the provisions of ' ��?'° the Board's Resolution No. 79-129 or 2r.y 2��ndmenc th�reCo). � �y.:�� . - • e. -irs+ '1 t'fi 1 • llate of Issuance Z8 EEBRUARY. 1983 ' & � f--.. � _ Signature _ , ' �;'s • QiAIA�f�1iV, BOARD OF COUNTY CC�S9ISSiOL�R�: '� ' Title t'i: 4'. ,�. - ^,� GRANT OF iJAIVER Th� undcrsi�ned, representing the Board of County Cammi.ssioners of Pitkin p�;•;°':,°' County, Colorado, does liereby grant a waiver of license conditions to the above � h`�� � � • named applic�nt as stated helow: • '`'��±' a. � . � �� Datc oF Issuance • • ._,� • � _ Signature i 4'�!� „ ' i � I • Title � . i �% ' ��� t �