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HomeMy WebLinkAboutbocc.con.014.1993 �;4, , , " y , , , .,,h ' i. ,";,; t;� i.: ' ,` � � ,', . �. : � `r, � '_ r,. �" 4 �s� '., ,. .,:. • . : .�r.� ���y .. 7».h.:. frl�r�+��' wj,ia*� r � ,��, � �� .0/; � )�it .;4;l.. �q � .h �� ("[,'i .�T .� � . [+�. � � f j.t• � - . ' ,�� MY';-�S.� � .uPl�' �, `.ayi �e y r � . . .. ... .. . . �� �� �.�"4�"�- � .._. .. . . . , fWA� ��1�7�t: . '� . . ., `.� .. .. � ;�„y�� .c�. - �� �,�'CL!l�.t� .%.�i. �LLc4./ vy'�,. f� U° C93�is' ,;�_;_. � ..���_;; . - :.`Y GRANT OF LICENSE/PERMIT � The undersigned, representing the Board of County Commissioners �,., of Pitkin Count Colorado, does hereb '''�`` Y, y grant a license to the �1X' above named applicant to provide ambulance service within Pitkin � K'="tj i� ( 1�-.. County. This license shall have upon it any restrictions listed ? �:" " �.j •.r Y,�`- below, shall be granted any waivers lisfied below, and shall be • i ; ,:�?.: = valid for the dates listed below, unless revoked by the Board '" j: pursuant to the provisions of Resolution No,. 87-1 � �*. .. � RESTRICTION9: . � �� ;. � :�, ! "---i WAIVERS GRANTED- ; �.f } , � f. ;�� � ' 4. �. .. THIS LICENSE IS VALID FROM/UNTIL: Januarv 1, 1993 De�ember 3L 1993_ � '!� ~ h . ��p,"' t 1,. .j;i":. f.. 1 } { .� 6 i f ! ' DATE• �0 � J i � CHAIRMAII, BOARD OF COUNTY COMMZSSIONERS ._._.`... ._..:.,_.. ..,_.____ .�._.._.._,. .._.. ..., _ , _ _ _..__..... .__._ __ . _ ._......---^._._._ _. ._...._._. � � � .��� � � � .�.�,. . • . ,�+� . ` ' , ,YA; ' ,, '' } ', '��'•} r-.w'�� � ,�.�; , � r ' S�yt;� y 1, �'r �, .��'� 7 X.RL't�� Z''M . � r i 4 c � N ��; . `{ �`'.' . � , j7yn ..; 1'J t�p'�'�� 's�'. � �^�' ..n' � ?�.{��.,c{�s.'`��4-:. � ��'�� kla. . .yY{ ..s . � � i �' � , � Y' '�. � � . .f'�'�k , . . ��,fy��{Yrl�. ' . .. t-1+�'��.. . . .. .. . ... A��.�'"Z.�:�� . ��. �:j • . +���.� .{' . � ;� 't.� ` ,.�,: ;'.'+, ;;�_. . �e j;,,,}',�, : �,.-:;: PITKIN COUNTY APPLICATION FOR AMBULANCE LICENSE ' - . �" � �s::... . PLEASE TYPE ALL INFORMATION "?,: '� 5y . SERVICE NAME: Snowmass Wildcat Fire Protection District `'�" }� ADDRESS: Box 6436, 5275 Owl Creek Road, Snowmass Village, CO 81615 �`-��Y? , 1 .": -. � OWNERS OR OFFICERS: Snowmass-�+lildcat Fire Protection District i .:��� � ` PHONE NUMBERS: 923-2212 ; ( �'s ..�.., iDESCRIPTION OF AMSULANCE: MAKE, MODEL, YEAR, LICENSE NO. ? Ford E376A 1979 �`�l�t.�7`�i� r�' ; ADDRESS AND DESCRIPTION OF BASE OF OPERATIONS: 5275 Owl Creek Road, i � - q<';:: Snowmass-Wildcat Fire Protection District Station �1 � . � PH ICIAN ADVSSOR• ers 1 YS . Dr. Steve Av COLORADO CERTTFICATION NUMBER: 27273 ? PHONE NUMBERS: 925-2961 (home)• 925-1120 (work} --. SIGNATURE: /,//) 7�tJ 5` . •t WAIVER REQUESTS: None "i �.` i t ' � I F 1�. - �5�:.., ,,..', 1.� � � :. APPLICANT: �IC 1-1A11�11 DATE:��II3IGo� . I. SIGNATURE• �^�-�"� i t,�, �+���:';7.,�..;,.. '�W:t.. �i �t ','�',:»�. � • . . v .`'_. y _'.;.. i _' �„-,..` - , _ . . __ .. . .. 1` . „> . . _ � .. . ` 1 ' . i .,�`;??�; . . � � . . . ` , � `�K�. . ��i