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Home My WebLink Aboutbocc.con.009.1993 �x +c ',1:. a' �::r, .�; � � , i � M1:� na'ti•; ' � ' ��.i4 :-,� �ir ! r ':�� . � � .;at.ia.w . �: .�,. � � ,��',�t ��}�,�3''J'�.�i,j'Q +'i,Y�1r�� r • ^�� t�,ahf.�e+� '�1y'y�y� ' .• 1N, t �� 1 _ �' �•�'�.l. . �y�. �e; . k, A iir�.��,'1, y yk:, . 1P� y� •M t'� Y.Y1.� b Y��t:.� . �{ , . ��. . ' y ..;:.�r+.��t.�. . .i�_ .� pt�Sti� . � , . . . ..... .. u'ic' ",l�t�'l: :i� _ .. � ;�:{��' .c � � '(��,,��'d Jf10!'1f1��'SS/lil/�.�d(�'.9�J' f'//Cf /RO��E J`�6u f�JbUy ,�'.i:;� �.r., � ,;. ��3-09 .:,�r .. � �..: .�,:` ti F GRAAIT OF LICENSE/PERMIT �' � , i� The undersigned, representing the Board of County Commissioners : �,�.:;.,` . � �9+�,��i of Pitkin County, Colorado, does hereby grant a license to the � ii�: # ��i t above named applicant to provide ambulance service within Pitkin � `�,,, �a' County. This license shall have upon it any restrictions listed �'�^'�y� ., : '��`�A ' below, shall be granted any waivers listed below, and shall be i � valid for the dates listed below, unless revoked by the Board � pursuant to the provisions of ftesolution No,. 87-? �' RESTRICTIONS: - ��r� �';�;, i+ t. } i Y 2 WAIVERS GRANTED: `� t s ,`\ -� \ i i . 1 � .� � ! THIS LICENSE IS VALID FROM/ITNTIL:January 1 1993 until DecemhPr 41_ tqqa, , ':� y.-. ! 't_ + ��+ i � i � � DATE: '�� '; , , `i CHAIRMAN, SOARD OF COUNTY COMMISSIONERS � �' ` 9;.' ;�;::y r.. . `'��.;'„. . . i d,.':,.`; . r.'�. ,.. _.___.__. .._...<..>.... ..,.� .. ._. .. . . _ .. �_ _ .�. ....._ ..... .. . _.... ,. ..._... . ...... , ., . .-. . ' .._....._...._..:_.. . .. ...._ -.. :..:_., � � ., :_; . \, . 1 . . . . _ • . .. , . ,�� . � ' ! ��Y. , . i�.��'M� ' � , _�'; �1 �;= I 1.' . . ' , ' t r: F ,,,r r .:.i +�.a� � i � -��:, A -., t; . �.4' T� � �... ��. � � �»ye,g'-`' ,a�i�. . S t� �� t � �+� , J'1:., ,l'a .. . ' ,i Z , �e)... CTA�3J1 L � f��,.i��r� �: � �ti �rc;. T . Y.? � �,,: .,H � �� tt'laj`� ��d.'i ��„ . i. '` '{k,"'+��'��`t'+F ``re.� ,a�, �pw � i.� . 7 � # � . ... t. �� -;:b..�� . .�'�.�==*I'�'E1N�"" . . . .. . . . � 4��'��.7"f.'�;:; • . �. �`� . :dy„ .r. .. „ry. . �Ae��C.� _- ��:'t. �`� --- . '��' �:f'. ;:t.- PITKIN COUNTY APPLICATION FOR AMBULANCE LICENSE ' �s'.��' 5:i"' `}�:;:;��. PLEASE TYPE ALL INFORMATION <� SERVICE NAME: �tyo.,3,MA5S �t L.UCn-T Fl CL�. �RoT�L-T� � c�7lC1Y��_C�T �; � ` r i. ADDRESS: �J t.l� avJL CaLc�t ttc� �1�1v41MOSC V il_SR�T.$�til'S ,$ 1 �i OWNERS OR OFFICERS: C,i9��- �n Jw,i.(I F:txt.��qNC.�J � � r"•'=.P. �` PHONE NUMBERS: 9 L5 -Lz� 2�. ' ��- � DESCRIPTION OF AMBULANCE: MAKE, MODEL. YEAR, LICENSE NO.-�R�n��.a41�� "+°'' , � '1 hCMtc-+c..a�v�c�.-A�M3�*IC. 11 �CS��'a �l�o�)�iAaZ-�M�'SU4�nfc�E, \)K1�at o Cc�.a.za�c 7.a.i3�Y sv�x.._ Grakv a 3vn+�n ou�cA, ADDRESS AND DESCI2TPTION OF BASE OF OPERATIONS:��r.n�.hs At�V�- y Es�soz Ct1��.�mncs C"-„1�.cia-�•-- Fi,�c-..�t--vsc l�`•��`s�� ir�, -lrz3S J�,Ke�y N�sr. �a'�"� o'-l'o I(AS7CC V'3K,DF� , . PHYSICIAN ADVISOR: � S /'I�/��•�. �'�j�"'.Skbu " COLORADO CERTIFICATION NUM$ER: Z 7�-�.3 � 3 'i Q '+ PHONE NUMBERS- 1�� II�� ` �; . ,y � SIGNATURE: � WAIVER REQUESTS: '� � �`` �' �q�T �V�i.�TC -- ,: t � � ? i � 1 F`•��-� 4- i �� ;,' i /-15�E�f At1cy WOS�irqt_ � � .��i 1 APPLICANT: ��c�n�n i-d. �J.4t.icc-r�,� DATE: ! 3 � �. .�� 1 - SIGNATURE s � S�/^ l- � J - �� l�.� i;1 , j��` . ' ,�h, i s,. I - `;��:::'_�: .. t - j �� v .; 1 ..� . .. . ... r � .. . . . . .. _.,:_ ._ . _ .. .. , ._�.. .. . 1 .. ..,:a-:.� ,.:,.. ... , .�. -:_. . ' i:. . . ..� ;,:. : -..,:.� . . . .._. . : , . .�,_.... . .. . . , . � / . . �� , � t�''N.x: , . ' . . . ,F,�?