GENERAL43260

• Permit No: M1996060
• IBM Index Class Name: General Documents
• Doc Date: 2/25/2002
• Doc Name: WELD CO REFERRAL
• Media Type: D
• Archive: No

FOR COMMERCIAL SITES, PLEASE FILL OUT THE FOLLOWING INFORMATION
BUSINESS EMERGENCY INFORMATION:
BusinessName:~// 1/r/Jn /n9rr~/a~ ~y/rS (~/r`°'tp~pne:97d~68~-5/S7
Address: ,3tZ71/9 (,/t/d ~ov~r~ ~ac7 27
Business Owner: }/4// Jrw/:t /~o rao/4Tia h Phone: `77°-3S 2 ~ (~°s7
Home Address: ~QZb ~/r~'/9uP, City: Gir~~ry, ~O. ~06,_7~
List three persons in the order to be called in the event of an emergency:
NAME TITLE ADDRESS PHONE
Aaronio f'arrrZ /yloKaSr~- ,gz7YYwc/L /? %y.;.rdto~r17a-675/^aYo~
~l) ~^ 70 33'~~dTz e ~ n
s(re/l Sq••[~'~C~ CjrHPr4/ /7°~gaSP-- //~/o/ liciC 9J.c/ f/rD'wrP 30J-~.s/- G//°9
~~ / ~/S l'G `' SS ~y-/'P(SO/!/I P~ ~:/rrrac 3ozi S//Li9vr G/rte/Py 97o~3zs-bos7
970'539'0909 C+P//
Business Hours: /;OO Q,,,- (o;oo,o~ Days:Jllogofur/ -.~,ru~!'q~
Type of Alarm: None Burglar Holdup Fire Silent Audible
Name and address of alarm company:/^ To ~n ~a .r) 9/`/ /~/T~iS.t GrrP~%,~r° ' $"06,x/
Location of Safe: /1Jo'/7 r
MISCELLANEOUS INFORMATION:
Number of entry/exit doors in this building: Z Location(s):
Is alcohol stored in building? ND Location(s):
Are drugs stored in building?~/ Location(s):
Are weapons stored in building?~~Location(s):
The following programs are offered as a public service of the Weld County Sheriffs Office. Please indicate the programs
of interest.
_ ~ Physical security check Crime Prevention Presentation
UTILITY SHUT OFF LOCATIONS:
Main electrical: N~/rti ~aST l•Or~7rr of /~;~o/rn~

Gas shut off: ~~~
Exterior water shutoff: ~~~' ya~~J /fJo~f/, e~ o~« ~/.~ ~ M rT~ /'
Interior water shutoff: 1/rte'/ s%n~
6