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HomeMy WebLinkAbout1.0 ApplicationGeneral Application Materials Community Development Department 108 8th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 PRE-APPLICATION CONFERENCE SUMMARY www .ga rfield-cou nty.com TAX PARCEL: PROJECT: PROPERTY OWNER: 2123-343-30-013 Heikkila Day Nursery Ryan & Iliana Heikkila DATE: 10/14/2020 PRACTICAL LOCATION: 12 Riverboat Drive, New Castle, CO 81647 ZONING: APPLICATION: Planned Unit Development -Riverbend PUD Special Use Permit for a Home Occupation I. GENERAL PROJECT DESCRIPTION The Applicant is proposing to operate a day nursery, also known as an in-home day care. The Applicant indicates the facility will serve less than 6 children. The facility will be licensed by the State and would comply with all state regulations. The home is located in a developed residential area with all streets and infrastructure improvements in place . Parking and drop off/pick-up areas would be accommodated by existing driveways and parking areas. At the time of the development of the PUD the Garfield County zoning regulations did not require any review for a childcare facility under eight children. However, because the use is not specifically listed within the Riverbend PUD the applicant must apply for a Home Occupation . In the Riverbend PUD, a Special Use Permit application is required for a Home Occupation use. II. REGULATORY PROVISIONS APPLICANT IS REQUIRED TO ADDRESS Garfield County Land Use and Development Code, specific sections : • Common Review Procedures, Table 4-102 • Submittal Requirements, Table 4-201 • Article 7, Division 1, 2, and 3 Based on the number of submittal waivers to be considered a supplemental meeting with County Staff is recommended prior to submittal to ensure all issues and waiver requests are appropriately documented. Please feel free to contact me to set up a time for such a supplemental meeting. The Application submittal needs to include 3 hard copies of the entire Application and 1 Digital PDF Copy of the entire Application. Both the paper and digital copies should be split into individual sections. Please refer to the pre-application summary for submittal requirements that are appropriate for your Application. V. APPLICATION REVIEW a. Review by: Staff for completeness and recommendation . Referral agencies for additional technical review b. Public Hearing : ~ Planning Commission _x_ Board of County Commissioners __ Board of Adjustment c. Referral Agencies: May include but are not limited to: Colorado Department of Social Services (permitting agency for day care/nurseries) County Building Department, Fire Protection District. VI. APPLICATION REVIEW FEES a. Planning Review Fees :$ 525 b. Referral Agency Fees: $ tbd ($ hourly fee for engineer review -will be billed during the course of the project) c. Total Deposit: $ 525 (additional hours are billed at$ 40.50 /hour) VII. GENERAL APPLICATION PROCESSING The foregoing summary is advisory in nature only and is not binding on the County. The summary is based on current zoning, which is subject to change in the future, and upon factual representations that may or may not be accurate. This summary does not create a legal or vested right. The summary is valid for a six month period, after which an update should be requested. The Applicant is advised that the Application submittal once accepted by the County becomes public information and will be available (including electronically) for review by the public. Proprietary information can be redacted from documents prior to submittal. 3 C. Section 4-105 Major Impact t fi .. j I !!:: Garfield County Major lmpec:t Review Proceu (Section 4· 105) I • 3-i.:~D ~1 ~ Pr'::•t-.1,~H~i.~,l!j1) Cc,,re!·~ \":]¢~ I •Applicant has 6 months to submit application •20bu1rne&1 day1 to rwl- •lf ll'ICOl'l'lpl ·I'll. ISOdlyt to Mmedy deflclenc:IK •Published , posted, :,nd mailed to .1djllcent property owners within 200 fMt and miner al owners, at least 30 day1 but no mor• than 60 daV9 prior to PlaMlng Commission pubNc hearing Step S: Referral, •21 day comment period •Published, po,tad, and malled to adjacent property owners witfiln 200 lf?e"t and mlneral owner., at least 30 da~ but no more ttian 60 da~ prior to 80CC publlc hearln11 •Applicant ha~ 1 year to meet any a:inditioll5 of approval 5 ce Garfield County Community Development Department 108 8 th Street, Suite 401 Glenwood Springs, CO 81601 (970) 945-8212 www.garfield-county.com TYP E OF APPLICATION □Administrative Review Dlimited Impact Review [2]Maj or Im p act Review OAmendments to an aroved LUCP OuR OM1R suP O Minor Temporary Housing Fa cility O vacation of a Coun ty Road/Public ROW □Location and Extent Review □com prehensive Plan Amendme n~ □P i pe line Develo p ment LAND USE CHANGE PERMIT AP.PLl €ATIO'N FOR.IVI D Development in 100-Year Floodplain D Development in 100-Year Floodplain Variance D Code Text Amendment D Rezoning Ozo ne District 0PUD 0PUD Amendment □Administrative Interpretation □A pp eal of Administrative Interpretation lAreas and Activities of State Inte r est □Accommodation Pursuant to Fair Housing Act □Variance □T ime Extension (also check type of orig i nal applic ation) I NVOLVED PARTI ES Owner/ Applicant Name: Iliana P. Heikkila Phone: ( 97 0 ) 309-9423 Mailing Address : 12 River Boat Dr. City: New Castle State: CO Zip Code : 816 4 7 E-mail : i-rami@hotmail.com Representative (Authorization Required) Name: Phone: ( ) Mailing Address : City: State: Zip Code: E-mail: PROJEC T NAME AND LOCATI ON Project Name: Heikkila Day Nursery Assessor's Parcel Number : ~ _\ _d_3_ -3 Y-~-30 -0 _/_3_ Physical/Street Address: 12 Riverboat Dr, New Castle, CO 81647 Legal Description : Special Use Permit for a Home Occupation Zone District: Planned Unit Development -Riverbend PUD Property Size (acres): .36 I PROJECT DESCRIPTION Existing Use: Single Family Dwelling Proposed Use ( From Use Table 3-403): -===-S_,_p_e_c_ia_l _U_s_e _P_e_rm_i_t _fo_r _a_H_o_m_e___.::.O.....:.c.....:.cu.:...!p_a_ti_o--=n====--- Descri ption of Project: __ ln_h_o_m_e_c_hi_ld_ca_re ______________________ _ For Appeal of Administrative Interpretation please include: 1. The Decision you are appealing. 2. The date the Decision was sent as specified in the notice (date mailed). 3. The nature of the decision and the specified ground for appeal. Please cite specific code sections and/or relevant documentation to support your request. 4. The appropriate appeal fee of $250.00. 5. Please note a completed Appeal Application and fees must be received within 30 calendar days of th e date of the final written Admi n istrat ive lnteroretation. REQUEST FOR WAIVERS Submission Requirements Iii The Applicant requesting a Waiver of Submission Requirements per Section 4-202. List : Section : D,E Section: F, G Section: J, K Section: And L Waiver of Standards □ The Applicant is requesting a Waiver of Standards per Section 4-118. List : Section : Section : Sect ion: Section : I have read the statements above and have provided the required attached information which is of my knowledge. I Signature of Property Owner or Authorized Representative, Title Date OFFICIAL USE ONLY File Number: ,Al PA_-i_i_'l, ~ Fee Paid: $_'7't_____,;?,_._o_O ____ _ RECEIVED GARFIELD COUNTY COMMUNITY DEVELOPMENT cE: Garfield County PAYMENT AGREEMENT FORM Iliana P. Heikkila GARFIELD COUNTY ("COUNTY") and Property Owner ("APPLICANT") __________ _ _______________________________ agree as follows : 1. The Applicant has submitted to the County an application for the following Project: __ _ Heikkila Day Nursery 2. The Applicant understands and agrees that Garfield County Resolution No. 2014-60, as amended, establishes a fee schedule for each type application, and the guidelines for the administration of the fee structure. 3. The Applicant and the County agree that because of the size, nature or scope of the proposed project, it is not possible at this time to ascertain the full extent of the costs involved in processing the application. The Applicant agrees to make payment of the Base Fee, established for the Project, and to thereafter permit additional costs to be billed to the Applicant. The Applicant agrees to make additional payments upon notification by the County, when they are necessary, as costs are incurred. 4. The Base Fee shall be in addition to and exclusive of any cost for publication or cost of consulting service determined necessary by the Board of County Commissioners for the consideration of an application or additional County staff time or expense not covered by the Base Fee. If actual recorded costs exceed the initial Base Fee, the Applicant shall pay additional billings to the County to reimburse the County for the processing of the Project . The Applicant acknowledges that all billing shall be paid prior to the final consideration by the County of any Land Use Change or Division of Land. I hereby agree to pay all fees related to this application: Billing Contact Person :_ll_ia_n_a_P_._H_e _ik_k_il_a ______ Phone: ( 970 ) 309-9423 Billing Contact Address: 12 River Boat Dr. City : New Castle Billing Contact Email : i-rami@hotmail.com State: CO Zip Code: _8_1_6_4_7 __ _ 01/04/2021 (Date) 12 RI\/ER90AT DRIVE LAND TITL E #GW232500 CRAIG ACCOUNT . . LO T 13 RIVE'.Rl3ENO, F')LlNG NO. 5 . . ACCORD ING TO THE PLAT THER EOF RECORDED DEC EMStR. ~. 19~7. AS RECEP TIO.N NO. 517550 CARFIELD COUNTY,' COLORADO, .#5 REl;3AR WITH CAP L,.S15710 l/5 Ri::BAR : WITH CAt;;i · LS15710 5 RE;BAR 1TH CAP LS15710 SCALE: 1'' "" 30' #5 REBAR WITH CAP LS15 710 I He:RtBY ctRtlPl' THAT '!'HIS lhl'RO~EhEff ~~TJQN CEfUflC:ATE WAS r'~-'Rnl F'OR~CAN WESTERN , MOR TGAGE__, THAi IT IS NOT A(.~ ·s~Vf:Y FU.TOR IW'ROYELt;NT SlJM:y PI-A.T, ANO THAT rr !SNOT TO Bt; RELIED UPON FOR THE EST.\BUSHMDIT Of n:NC[, E!Vl.DING ~ Oll;1K~ rurun 1"4PROV~ UNES. I n.JRTIU c~nrv 1HE 1Mf'llQYD4£Nti ON TI-£ ABOVE DESCRl!JfD PAmL 01'1 TliS P~ TE, _:___Jj/.12/.$.8 ' E;XW'T UTUT'I' ~CTIQNS, ~ OOlt:L 'f WITl♦I THI: llOU-Pllfti:5 Of M PAA~L. O~PT AS . . f.)-lo~. THAT ·ncRt ARE NQ f.'NCRO~CHli£NTs U"ON n-t: 1ESCfl1oco PR£~s er IMPROVEMENT'li PN ;.N:Y ADJOtMNO Pm«SE'S, Dem ,1.s NOTf.D, ~D4CATED, "'"° T~T Tl-f:Rtt IS NO e:ViJf:NCE ON 51GN or ANY E~T CROS'S~G OR ~~'AN'I' PAR\" Of' SAIC PARC.ti.., OICEPT J.S 7G~~ L -)) £~,n~~-• :::r F'Ol,)NI) PIN Project Narrative Special Use Permit for Heikkila Day Nursery : Iliana Heikkila 12 River Boat Dr. New Castle, Co 81647 970-309-9423 The proposed In-home Daycare will comply with the zoning requirements of Garfield County district in which the use is to be established . It will also comply with all other applicable requirements from the state of Colorado. Application for Daycare License has already been submitted to state. All training and certifications requirements by state have been obtained by applicant. The use of Daycare is in harmony with the character of the neighborhood and compatible with the surrounding area . It is aimed at providing safe, caring, top quality childcare services to families in surrounding community. It is located within Riverview Subdivision. Childcare services will be provided inside of applicants Single Family dwelling. Hours of operation are to be from 8am to 4:30pm . In regulation with state licensing Daycare will provide care for a maximum of 8 children. 6 children under the age of 5 and 2 of school age. This number is to include applicants 3 children. The use will not have any undue burden on available infrastructures. Daycare will not result in undue traffic congestion or traffic hazards. Existing roads leading to home as well as driveway are adequate in the increase use by an estimated total of 5 more vehicles at drop off and pickup times. Parking is adequately provided. Home has pull through driveway that will allow parents to pull off from main road and drop off and pick up children . Daycare will not cause significant air, odor, water, noise, or light pollution. With the exception of one planned hour a day, weather permitting, all Daycare activities will be done inside applicants home. Any outdoor activities will be within applicant's fenced yard. All sanitation requirements will be met. Water and Sewer services are provided by Riverbend Water and Sewer and they have confirmed it has the capacity to accommodate Daycare additional use. 1/5/2021 Parking .webp (1536x 1024) file:///C:/Users/i-ram/Desktop/Maps/Parking.webp 1 /1 Division 2. General Resource Protection Standards Iliana Heikkila 12 River Boat Dr. New Castle, Co 81647 970-309-9423 Applicant requests a waiver for all sections of Division 2, 7-201 through 7-208. In home Daycare facility will not have any change or effect on lands adjacent to or directly affecting agricultural lands, wildlife habitat areas, waterbodies, drainage and erosion, air or water quality, wildfire hazards, natural and geologic hazards, or give cause for reclamation. Division 3. Site Planning and development Standards 7-301. Compatible Design Single-family dwelling units are exempt from this section. 7-302. Off-street Parking and Loading Standards. Single-family dwelling units are exempt from this section 7-303. Landscaping Standards Single-Family Dwelling Units, Accessory Dwelling Units, Secondary Dwelling Units, 2-Unit Dwelling Units, Industrial uses and all uses located fully within a parcel of land in an Industrial Zone District are exempt from this section. 7-304. Lighting Standards. Home Daycare will be making no changes to existing lighting provided by Single -Family Dwelling. All existing lighting is in working order and shall be maintained regularly to ensure working order. 7-305. Snow Storage Standards All residential uses except for multi-family are exempt. 7-306. Trail and Walkway Standards Single-family dwelling units are exempt from this section. Photos off enced backyard where any and all outdoor Daycare activities will take place. 1/5/2021 Backyard2. webp ( 1536x 1024) file:///C:/Users/i-ram/Desktop/Maps/Backyard2 .webp 1 /1 1/5/2021 Backyard .webp (1536x 1024) file:///C:/Users/i-ram/Desktop/Maps/Backyard .webp 1 /1 Listing of Adjacent Properties within 200 ft. Parcel Physical Ad Owner 2 .12E+ll 11 RIVERBC Account Nl Mailing Address R170389 2.12E+11 31 RIVERBC R170390 2 .12E+ll 55 RIVERBC AYALA VILL R170391 55 RIVERBOAT AVENUE NEW CASTLE, CO 81647 2.12E+ll 159 RIVER R170399 2.12E+11 181 RIVERE BOTTROFF, R170400 181 RIVERBOAT DRIVE NEW CASTLE , CO 81647 2.12E+ll 12 RIVERBC CRAIG , JER I R170401 12 RIVERBOAT DRIVE NEW CASTLE , CO 81647 2.12E+11 178 RIVERE MACFARLA R170402 178 RIVERBOAT DRIVE NEW CASTLE , CO 81647 2.12E+11 152 RIVERE HANSON, J. R170403 152 RIVERBOAT DRIVE NEW CASTLE , CO 81647 2 .12E+ll 34 RIVERBC SOLIS SAN( R170404 34 RIVERBOAT DRIVE NEW CASTLE , CO 81647 2.12E+ll Not availat RIVERBEN[ R170409 PO BOX 1989 GLENWOOD SPRINGS, CO 81602 2.12E+ll 335 COUN l GARFIELD ( R017243 839 WHITERIVER AVENUE RIFLE, CO 81650-3515 2.18E+ll RIVERBEN[ APB HOLDI R170278 5670 BRENTWOOD DRIVE HOFFMAN ESTATES, IL 60192 ROW Not availat cG Garfield County CERTIFICATION OF MINERAL OWNER RESEARCH This form is to be completed and submitted with any application for a Land Use Change Permit. Mineral interests may be severed from surface right interests in real property. C.R.S . § 24-65.5-101, et seq, requires notification to mineral owners when a landowne r applies for an application for development from a local government. As such, the landowner must research the current owners of mineral interests for the property. The Garfield County Land Use and Development Code of 2013 ("LUDC") Section 4-101(E)(l)(b)(4) requires written notice to owners of mineral interests i n the subject property in accordance with C.R.S. § 24-65 .5-101 , et seq, "as such owners can be identified through the records in the office of the Clerk and Recorder or Assessor, or through other means ." This form is proof of applicant's compliance with the Colorado Revised Statutes and the LUDC. The undersigned applicant certifies that mineral owners have been researched for the subject property as required pursuant to C.R.S. § 24-65.5-101, et seq, and Section 4-101 (E)(l)(b)(4) of the Garfield County Land Use and Development Code, as amended. As a result of that research, the undersigned applicant certifies the following (Please initial on the blank line next to the statement that accurately reflects the result of research): _ I own the entire mineral estate relative to the subject property; or ~ Minerals are owned by the parties listed below The names and addresses of any and all mineral owners identified are provided below (attach additional pages as necessary): Name of Mineral Owner Mailing Address of Mineral Owner J-1 a fY\ '-H·•r"n f<. l'\1.1 n f' 0.1'\ ~{". l )(\~ (\ C) uc"\ (""\ I acknowledge I reviewed C.R.S. § 24-65.5-101, et seq, and I am in compliance with said statue and the LUDC. Date ~ . , ·. BOOK ';;>72 P!GE730 in ~173 at Page 154 as Reception No. 82344 (S E 1/4SE ¼, S~tion 34); •rig ht .of the propr~etor ofWv~ or lode to ~xtract _and remove his ore therefr om, should the same be f9und to penetrnte or inte sect_. the premises hereby granted, as reserved in United States Pa'tent recorded May 20, 1 , in ~k 12 at Page 155 ~as _Re~ption No·. 13991 (NEJ,4.SE¼, S~tion 34, and W½SW¼, .. , ion· 35); ~ment and right of way for electric transmission lines , as granted to the Public . 1c,e·Company bf Colorado py·.c. W:.Darrow and C. C. Parks in the -instruqient -rec;Qi;d¢d ·· .. · ruaiy · 1 i , {9_67; i a Book 3·g2 _at P~gi l7(f as Reception No. 237076 affecting the S 'h, Sec.tiqp , : . ;·ngnt .o.f -way 'for 'ditches · or cajlrus :co.ns,tructed by · the authority .of th_e .-United ;states ,as . · ,;· .. I:~Sen'.e.d _.i n:. Oni ~~l.~.tatis':-~~I~~~ _r~~~cied Ap:ii:_s, 19~3, in:~~"?~ At ~ag~'J54.J S R~.i p,ti q~· :: ----:::· .. . . ·. No. ,82~44.:(S~.¾S;B¼, S~!!9fl 34);._reservation m Patent recorded Apnl 5~'-19~3,:m. J3<)Qk7,_3. ~t.-· "·. · ,-~-.. . . . ' Page fsf~s R~.~pt_i q·n· N c{:. ~f.3~4:s~ted ~s · f o,il9.ws:_ ·· "Reserying,. howev~t; :t_o,'.t tle _(J:nited -~ ~t~~'--. ·_ ·'.' :· .. ·-~ : · . · . al J°coal io···the land.~ so.en ie'red ;·and to it or persons authorized by it; ·th~·'ngh( .. to .·pros_pr.,c (for ·, :. _: :'.:.··, .. . · . mine -and ieritoye _~~a\ frorrd he.~rne upon compliance with the conclitiol)s ·.of and -'subject 'to ·.the : :·, .·· .. I • • ' ,-1 ' I • ~ ' , • • • • • • • 1 1 • • • · __ 1~1'.1i~.ti~n·~::?f•t~~ ·f cr or ~~~~!.{:~, _190Q (35 Stat'.· 844)l {SE 1/4SE¼,Sec_~~n 34); easeme_n~ __ and _ ·._ · .. :-: :> ·. · p gh~ ·of: 'YaY,J o_r ·cattle dnv_e .as _gr<!9-~ed to ·Frank De]an y !by Paryl. G .R1ch~dson and_ \ymifre:d . ' · · . : ·. Richarcison··in th~.'ins _tru ment·rAC9rdoo F ~bruary 24, 19'66; in Book;.374 at .Page 269 as Rec·eptiori ·, .. · :.. . · No. ;_2_3360§;.':ea se_rfl e·n(arid '\ight ·of_ war,· for . electrical trans·qiissiori line ·~s granted to The -P.uqlic :-... ·._ . '. . S~rvfr;e ~oJhpa~i of.¢0Ior:3:90 ·1,y _-paryi '9 : ~~b~y8 s~n -an4 ::-w~nifred ·:C. J~fohardso'ri, i~ . ..-tBi .. :: _. . · .. : ins~r~me·~_f r~qrcl~ -·~u~i1sf:~8; _)91f; ::iri'~k·.4.~.~ ... _at..'P~g~<?42· ~s -R~ep~on :J',fp.-·:2549,~7.,.:_; ~! ·:r_ ,: affe~ting ·property/:iii \~1:~:. S? ¼· :of :~eclfon ___ 34 ~4 °SW .1~·_j >f :s~tion,--35; -:t erms; COQ9*tjops; .. , . _:. ·=.. ,· · ob1igation i anci ~res trictio 1fa·-as :q\:mtafried ,in ii?ro t~ctjvi .,c9ven~t~:rec\>rded Nov·embe(2~./1.9_79., :. ;_·_. ... _ · . . in Boole ~3·9 -~ce~ge ' . .9~5· as .~eception~:&o. ·2~9.714; r~strktio.ri's arid easeme11t~· ~s ,.s~:owii"'pn th~~-----.. ,:-,--. .. : . R~c~r~:-~Ja f of Ami~~~cr"R:l~~!b~n~ Su~~iy_is,i,O!(FiWji{~o : 2,\ec{>rded. 1-:1ovem~r/i~c)~7~; ~$· ... ·. '. .... : ... :_ ... ·' Reception ·No.; f299710; undivided ·orie-half interest)n,:.µ_l oil,-gas and •ot1je1Jriin~raFrigtiti as / f ,; ' ... ·': . ·.• .··r~sei-ycili_by .,~i9yd}W .. J'~ttl ~,:~1 J. Tuttle /fyicL.loyci Tu(tle ·ang Wayne .K~ ·tuttl~~~~{~~.:'d_eec(·\ _ .'),-. ·. ·. -~; · -r~~or9<:Cf ·s ·¢pt¢mber :·23 ,, 1955;.·fn .. BooJs .287 _.a~,P~·ge ·435 ~s Reception :N9.;_i~J5~-.~af!d_:a1i°y,~an c(.;: ;_:'-':. : : _ _.::. ·,~II ' ~ss_!i~ip~!1ts Jher,eo_f., or ;icfr~!~·s°(s_ .: thet~ifl. (S ;½/~ectjon . 3.4 );· ~~m~~.t-, ai)4 :--tj~tif 1_ot\waf.r.~for '.,. < ·.' ~: -; :'. ;-. . . , · public ·-ac·cess .. as 'stated i in cAgreeme"i1t · betw~n Daryl Richardson • ·and :'-tbe ?Game .~and ':\Fish ' .,·,: .. _· •.• · Commission d~t~ ·¥ay .is, -~9,63;··r~orded' ·1~11e ·2is,. 1963, in ~k. ?si_ at "P~g~·.·,z1 {"a/' :<. ·-·~: _: .· .. Reception No. 221968; all oil, gas and 9ther minerals as reserved by .Hamilto~ ~:_.pu~·~an, Jr. ' in the deed to Cunningham Construction and Development Co. recorded May 28, 1980, in Book ... . -.. 549 at Page 172 as Reception ·No. 304197 and , any and all assignmynts _ thereo(or. in'(erests .. ·-._.:r -~.· . . . . . . ... . . -~ . therein; and terms, conditions -and effect of the Stipulation in Case No _. s1cv239···(Riverbend ::.~,{.f' ... :· . Homeowners Association, Plaintiff, and Cunningham Construction and Developmenf";co:, }_A'f~ .. ~;:\J • I • • •-f 1 • • • ·•-,•~':':-:;l,•i '.\~•1 l ;:_ Defendants) recorded January 12, 1990, in Boole 771 at Page 46 _as Receptio.n No. 4~~-2:~,i~l~:,:}tr~;?,~~lJ}t 1 : 1 : 6 • • • 1 1 • r,,1t~•~i~~i11~;:~~/ "•(;;:i.Zt~~E:t{t{~j:"• SIGNED .th' 1~ d fF b . 1990 . . · .... · . .,;.--;;-1 -:.--..17·,, ... -.... ~""' ilf-!,.,~,\ ,· •. 1s~ ayo e ruary, . . ... ·",'!";;r ....... .., ~,, •. • ..... - • • • I .i/.;:~--_-,C\J,..._(.r;:_,,,t ••;: I••,:_::•~~-.. ~;:-:,■,•■(.••.~•~•■, '(,'::: • __ .14.• •• e;.W .. :1 , ,1 ,.-:, 1. .. • • ., ,-:; -(.. .• f 4u\" ',-:, 1, ·. . . :~ ·•::t .. : ,-..L . ~ ~ •• ,_,. ·, . . ,,, -J • i f ,\ .--r .. :: .... r.:y; --= =-:. : · CUNNINGHAM CONST-RUCTION kNb V ?r f;i : !'! ~ 'DEVE OP . Teo' c ··1·· ct' v•···'~I ;, · L..: •• 0 :.-·; . • L · N .. , ;a i o ora p ~~-·.: r:i ( ··v.~ •,,_._.; r: .f -~ . . \ /•·:::._,:.--}-~' •.. \') / . '1 . ''o ., .... t','-.. '';~ '1 1" r .::1.n.-~i.' .... -- ~y: .-·:·1{~t!~1i.~:~;~~;;~;;~~~i ;"· T't-'o'"-t--t---------__,_-____ .-.. -,-•.· ' -· •• -i"• • -r✓ j ;, '30411~••i; 7 lOt.'l. ;'., 80, .,.,, .. ,,. Hamilton R. Duncan, Jr. Arapahoe Cmmi..nghaM Construction & Develo~t Co. ;, 1 ,,1 •1·••l':tti•1r ,,,-g-;1nizl'd and l':-.:1--,111~ i.11d,·• ;i1~,! ,,:-·. jl i ,, •• ,t",1 ,. l,,\',"' ,:·: , °'t:11,.,,,r Colorado ,.•,lw«-,•.,,,,;I',.,,-. ;,,,_,.,,.~"'"1,1,.. P.O. Box 418, Vail, co 81657 ' Rt:c-ordtr Rf.CORDER'S STAMP MAY 2 8 19&0 rrm lffllDT.IJY m - L_ _____ --------- \\Tl'-'E~~ETII. Th;11 1 ill' :-:ii;! ,,;ti·• y 11 ! t t,,, !'11 .-t p:1n. 1,1r :ind :'1 ,.;on:-1deration uftht" :-;um of Ten Dollars and other valuable oonsiderations--------------DOLLARS tut IH· ,.:a1ol p111 ¥ 1d r ii,· f11 l"'l 1,:11",. ;n ;,;\n•! p:iid I,> ti1 ,· l"'a1d (':Lr t:-,,ft lw :-:e1.·ond pan.th ... re<"t-ipt whereofi:-. \w1 (~h~ ,. 11llfl•..,:--t•d un•I n,·kn11wi1-dg(••I. has .1:-ra11t1·d. i,;1 !·!.-;i11i;-d . -•di! ar,d 1•1111•. i·:-·t•d. and hy t hl':,.t' JHl1:-.ent:--(!oes ,c-1ar·t. !iar,l!ain. :-.1.·ll. 1•1111\t•r a11d ~·0111'i1111. u1n11 ! :w ,.:aii: 1';1,·t:: 1,J Lh•.• ::t·u,nd 1•a l"t. it:-~IH'(1 :-.-:,)I':,: an(l a:,si,.rns foreVP.t', a! I 11f l ·w f r,l111 W ll\1£ ,ll":-'l'J'ii,l•d l11t S nr pa!·,:,·1 S t,I' !:1 nd, '-:I !I::! l . :~·in}! a1,d h1•1 r:.I!; 11 t lw ,•,,.11111 ,,f Garfield as set forth in Exhibit "A" attached hereto and made a part hereof, reserving h:wever, unto the Grantor all oil, gas, or other minerals owned by Granter an or under Parcel 1, Exhibit A. The party of the first part agrees that the exploration and/or renoval of the above res~ oil, gas, and other minerals shc>ll not interfere with any use of said property by the party of the serond part or its sucessors and assigns. This conveyance is made pursuant and subject to the provisions of that certain contract between the parties hereto dated ,Tanuary 4, 1978, and amended Noverrber 24, 1979. (unnumbered property) TO(;J•:THEH \\!t!1 :11: ;;!.d :-:!1:.:,1;:;:r ilw !.,•~1•.J,tam1••1t ... :;1111 ;q ,,,:, tPn:11w ... -~:,l'!"l•untu l11•lo11~ing-.. .-in anywise appl'l t,1i11!rq,!. and· iw ! • 1, , -••ll :!: ,! 1 .. ., 1·1.~, .. )!:-, 1,·in;li11dL1 I ;,:11d 1 i•1:i.,i,Fl"1':-:, 1",•11, ...... 1:-:-.ue ... and I r ,ifit:-: t hl'l't'"f; and all ~ he l..':-.tat, .. 1'1.L:.li 1., 1t 1, .•. 11:~ .. ! ...... 1 .. -::, i !1 a,;,.i ,1,-ii,:1 rid w ·a1.:-1ll'n:1· 111' 1 h,· :-:a:,i 1':11 t y •d· i h,• r, • ... t J1ar1 \•il hl•I' in lau· or t'qllity. ,,t. ill ;1rnl :,, : 11,• :,1 .. ·., !,;:• L.', :11 •,l !'' 1 ::: : 1, ... w!t \:: li1• h1•1 ·,•,lil i1Jllt•n! :-::noi i1\1P'll ll'lli,ri,'1•." 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Jst:.U,! ."'r \ 11•: ( ., , 1,1, :1: \ i:• • -....·· 1, ~ ;1,· .• ! 24th 1:1 SQ.1 ;· Hamilton R. Duncan, Jr. .( . EXIII!HT "A" PARCEL 1 A par cel of land si.:uat e d i n part o f t he NEl/ L•SWl/4 and t he NW1/4SE 1/4 of Section 34 , Township 5 South, Range 90 t~e s t o f the S.i.xth Principa l Meridian in the County of Ga r fielt.i , Stat e o f Colox-ado. Said parcel lying no rthw este .:-ly o f t.:hc no rthwes te rly right-o f -way line fo r a county road as con - structed and in place and easter ly and part of a fence a s constructed and in place. Said parcel being more pax-ticular ly described as follows: Commencing at the Southeast Corner of said Section 34, a rock found in plac.e; thence N 62°02'56" W 3357.89 feet to a point on said right-of-way line, said point being also in said fence, the True Point of Be~inninf; thence, leaving said right-of-way line N 24°09'39" 744. 1 feet along said fence, thence , leaving said fence N 24°09'39" W 173.25 feet to a point in the Colorado River; thence N 72°53'00" E 489.34 feet along said river; thence, leaving said river, S 36°21'29" E 730.23 feet to a point on said right-of-way line; thence, along said right-of-way line, S 53°10'00" W 655.91 feet to the True Point of Beginning. Said parcel containing 10.61 acres, more or less. PARCEL 2 Following de~cribed easements: A Water Storage Access Easement, being 40.00 feet in width, situated in part of the SE1/4SE1/4 of Section 34, ToW11sl1ip 5 South, Range 90 Wes':. of the Sixth Principal Mer i dian in the County of Garfield, State o f Colorado. Said strip being 20.00 feet each side o f and parallel with the follow- ing described cent erline : Commencing at the South east Corner of said Section 3L,, a rock found in place; thence N 45°33'36" \.I 1358.90 feet to a point on the southeasterly boundary of the Amended Riverbend Sub- division, Filing No. 2, the True Point of Beginning for said strip; thence, leaving said Filing No . 2 , the following thirteen (13) courses: 1. Thence S 60°13 1 40" E 30 feet. 2. Thence S 29°46'20" W 17.11 feet. 3. Thence S 18°46'58" W 133.34 feet. 4. ThencP S 39°53'37" H 154.97 feet. 5. Thence S 10°53'35" E 126.30 feet. 6. Tlience S 76°54'43" E 302.59 feet. 7. Thence S 89°45'28" E 123.04 feet. 8. Thence S 76°38' 05" L 111. 06 feet. 9. Thence N 77°36'15" E 259.31 feet. 10. Thence N 19°'.:,2'20" E 306.48 feet. 11. Thence N 20°32'03" W 100.63 feet. 12. Thence N 12°17'49" E 63.99 feet. 13. Thence N 77 °42 '11" W 20. 00 feet to a p oint: on the southeasterly bounJary line of a 100.00 foot by 200.00 fo~t water tank storage easement, the Poinc of Terminu$ for said strip. l.itility Easements over along an<l across Strips E, F, and G, each being 40 .00 feet in width , sit 1ated in part of the NWl/l1SWl/l~ and the SW1/4NW1/4 of Section 35 , Township 5 South, Range 90 West of the Sixth Principal Meridian in Lhe County of Garfidd, State of Co l orado. Said Strips being ~0 .00 fe-::t each side of and parallel with the following described centerline: STRIP E Conmencing at :he Southwest Corner of sai<l Se ctio n 35, a rock found in place, thence N 13°10'30" E 2563.38 fcf!t to a po i.ut on the Norhteasterly l i ne of a 40.00 foot by 100.00 foot utility easement, t.he True Point of Be,innin_g; thence, along said centerline N Z17°02'11" E 16 .85 f ee t to a well as constructed and in place, the Point 0£ Tel.Tnin·Js for said Strip "E". STRIP F Beginning at the Point of Terminus of said St~ip E, the True Point of Beginningof Strip F; th ence, along said centerlrne- S 60°16'09" E 202.37 feet to a well as constructed and in place; thence along said centerline S 60°16' 09'' E 20. 00 feet to the Point of Terminus of said Strip F. STRIP G Comnencing a t the Poin t of Termiuus of said Str~p E;, the True Point of Beginning of Strip G; thence, along said centerline N 70 6 14' 57'1W 202. 76 feet to a well as constn1cc~d and in place; thence along said centerline N 89°49'4.'.i" W 4lf8.46 feet to a well as constructed an..: in place; the:1ce, <1long said centerline N 89°49'45" W 20.00 feet to the Poi.nt of Tenni.nus of said Strip G. A utility easement being 30.00 feet in width, situated in part of Government Lot !1 of Section 5, Townshi p 6 South, Range 90 West of the Sixth Principal Meridian, the SW1/4SE1/4, SE1/4SW1/4 and Iffl/4SW1/4 of Secti on 34, Township 5 South, Ran ge •9() West of the Sixth Principa l Meridian in the County o f Ga rfie l d, State of Colorado, Said st~ip being 15.00 fe e t each side of and parallel with the following described center line: Ccmmencing at che Southeast Corner of said Sect i on 34, a rock found in place; thence S 88°23'01" W 176J.2 6 f eec to a point on th('\ centerline of an irrigation ditch as constructed and in place, the Tru eo Point of Beginning_; thence, leaving said irrigation ditch, N 47 6 59'16" W 825.35 feet: along said easement centerline; thence N 33°50'00" W 1132.£>8 feet along said easement centerline to a point on the southeasterly right-of~way line for a county ro a d; t h ence N 23°32'54" E 161.87 feet, along said easement c e uterline to a point on the northwesterly right-of-way line for said co .. nty road, the Point of Terminus for said easeme:,t. An access and utility ea sement being 80. 00 feet in widtt• situated in part of the NW1/4SE1/4 of Section 34, Township 5 South, Range 90 West of the Sixt~ Principal Meridian in the County of Garfield, State of Co l orado. Said strip lying northwesterly of and parallel with the Northwesterly line of Riverbend Subdivision riling Number One as on file in the Garfield County Records ~s document number 281326. Said strip being 40.00 feet each s ide of. and parallel with the following described cente rline: Commencing at the Southeast Corner of said Section 34, a rock found in place; thence N 52°41'50" W 3075.03 feet to Northwest Corner of said Filiug Numbe r One; thence leaving said Filing Number One, N 36°50'00" i.J 40.00 feet to a point on said center- line, the True Point of Beginning; thence the following three courses along said centerline: l. 2. Thence N 53°10'00" E Thence along a curve 4128.53 feet and a distance of 229.94 E 229. 91 feet). 330,00 feet. to the left, having a radius of central angle of 03°11'28" a feet (chord bears N 51"34'16" -2- J. Tlw11ce II l11J"'J;i' ;/" 1: ·1r,.,,.,,J Lt·t:, Te i:111i11u:; o I 1::1 id ,·,·11LLT l in,.•. l'o i Ill /\ u i.Li ty ',\:;c •lll<'ll L \l c•i 111•. ,n .r10 f l'\.'I i 11 wi dth, :,i l 11:1(1,d i11 jHlrt o f fHH/l 1S\J I /l1 o[ !jt•ct io n J'i , 1.l w Nl~L/1,SU/.', n11tl Ll 1 · SE1/4Sln/L1 of !icci:ion :JI,. Tmmsb · p '.> South , ll ::ing e 90 \h~L of the Sixth Pr.inc i pal Merio·:rn in thci Coun c y of G;u-ficld , State o f C,o lora uo, Said :,l:.J·.ip bei:11; 10.01) Ce ce c-.rch :;ide of and parallel wi::i1 the fol lowing de~c .ibeJ c:cntcrl,inc; Cornmcncinr, ;1t the SnntliC'ast CornL•;-of s;1i,I St'ct ·i,1n J/1, .1 !'!•cl, found in pl1ce; t·lurncc U 05°46 1 17" E l6'.:i8. 21.J [r)et t,; !! point.: on an existing waterline, the True Point of Beginning; thence, leaving saitl · .. iatcrline, S 54 "2T'""5iY '--TI l1'.>l . llteet; thence, S 32°40'42" \-J 260.58 feet; then.::~ S 09°17'52" U 23.30 foet tc a point on an existing waterline the Poi11t of Terminus for said easement. PARCEL 2 An easement, for utility purposes, situated in r,1l-t of the NE1/4SE1/4 of Section 311 and the lJl,Jl/l,S\Jl/4 of Secti.on 35 in Township 5 South, Range 90 West of the Sixth Princip.il Meri- clian in the County of Garfield, St ale nf Colorado. S.iid easement consistinr, of two parcc)ls (Parc e l "A" anu Parcel "B") being more particularly describeo as follows: PARCEL "A" A. strip of l:tllll Jn.oo fC'et in wiJtl), beinr, -lS.00 f,;L~t each side of and parallel 1..:ilh the following described centerline: Commencing llt tlH: Sn•Jtlicast: Corner of s.i.i.c.l Sec ti.on 311, ;1 rock found in plac•: Llw11c1' II 11,0 37'14" W 2llt).5H feet to a pojnt on the castc.•1·1,· bo1m<lnnr line of the Amended Hlvcrliend Suli- clivisi()n, Filiiii: !111. 2.° the True Point of lk;'.i tmin;,: thence leavinr, i,aid e;isLL':--ly h11unJary line, the following eight courses along said c e nterline: 1. Tlll'llCC' II U "7"()/' 3,~,: E 16.2} feet 2. The11c1.: ,. ., 7 ] O ~ ] I s :) 'I E ~.'..27.9l; feet 3 . Thence s 5 5" 3 h ',, :.!" E 176.00 feet /1. Thence s } 1 0 :! ;.; ' ~;. ~ '' E 1139. 88 fe>et 5. Thc>ilCC' C' ., h l" JI 'J 7'' E 91. CJJ feet 6. Thence s 7 I C ') / t :· • ff .J •-I .J .J E 1/14.-':9 feet 7. Thence ii 57°11(:'J:l" E 71,. 71 f C r! l 8. T:1ence ti 2:.'.'Jb''.iJ" E 840.45 feet to the Point of Tcn:Ii11u:; of said easemcn:: .::enterline. PARCEL "ll" Beginnini:; at said l'oi11'. or Tcnn.i.1111 1;, Lhc• True Poi nt ti f l.l,·ri1111i111· of said Parcel "l\'1;t:lic11cl', lcnvi11g [;;1id cell er! in c 1TT)7T2JT0Tr-'-' w 50.00 feC't; tlwnct• [J 22°]6''jj" E /10.f.lO reel; th<.'!lCl' :; 67°23'07" E 100.00 f<•C'L ; the11cl, S 22°](,''.jJ" W l,lJ.00 fc-ct; tiH'11Ce N 67°23' 07" W 50. 00 feet lo tlte True! Po i.11L of Begi1111i11r,. Said Par•.:el 11 13 11 containing D. l,·1 acres mono or les3. P/\!~CEL 2 An easm,ent, for 11!:illt_v purposes, :;it.uat"d i11 r,:irl of the SE1/4SE1/4 of Set.:tio11 V1, Township 5 South, l{n11/;c> 90 1Jc?sl nf the Sixth Princip;i l fh~ri .di.;in i.11 lhl' Cou11ty <>f G;irfir-L1, Stat.l' of Colorado. S.:dd easc,mcnt cnnsi:;Lint:. o[ Lw11 p;1cccl:; (P:1rc:el "C" and Parcel"!)"), 13einr, more p.trlicularly described as follows: .. PARCEL ''C" A str ·i.r of l;rnd 20.00 f1•t•t in side of ~ntl pa,_·,1ll1•L wlLl1 the Commencing at the Southeast Corner of saiu Section J4, n l"ock found i·, rlncc, thc11cc N 36°53'31" W )l137.03 feet to., pr,.int on the easterly bounJ3.ry line of the J\rnemlc<l Riverbcntl Suh- division, Fil.i ng lfo. 2, the True Point of ~ctinninrr; the11cc leavi11g sai<l ca~te1ly :loun<lary line, the f ol owinr, five courses along sai<l ccnterli11e: 1. Thence r1 31 "12 '!13" E 20. 71 feet 2. Thence s 03°1.5'53" w 71.CJl feet 3. ·4~ence N S2°S5'33" E 312.:d feet 4, Thence s 84~/f/3'31" E 221.112 feet 5. Thence s 12°17'4.9" w 111. 20 feet to the Point 0£ Termi.nus of said L:asement centerline. PARCEL ·•nu Beginning at said Point of Terminus, the True Paint of Becinning of said Farcel "D", th en ce, leaving sai<l easement centerline S 77°42'11" E 150.00 feet; thence S 12°17'lf9" W 100,00 feet; N 77°42'11" W 200.00 feet; thence l1 12°17'49" E 100.00 feet; thence S 77°42'11" r: 50.00 feet to the True Point of Beginning. Said Parcel ''D" containing O, 46 acres, more or less. -4- Application for Child Care Licensing for State of Colorado Child Care Licensing Family Child Care Home Original License Application License Fee Received I Application # Before Getting Started STATE USE ONLY I License# COLORADO Office of Early Childhood Division of Early Care & Learning I Licensing Specialist • Please type directly in this application form (preferred) or complete using BLACK or BLUE INK. Applications will be returned and processing will be de layed if w e are un able t o read your handwriting! • This application is for ORIGINAL child care home licensing applications ONLY. An Original Application is required if this is the first time you are applying for a child care license, if you are changing your license type, changing your physical address, or if you are adding or removing a secondary applicant who provides child care to your license (e.g., spouse). • Do NOT submit this form if you want to make changes to your licensed space (add a basement, add or move a room, etc.). For those changes, please complete and submit the "Child Care Change Request Form". To add/remove residents (other than Applicant #2) living in the family child care home, complete and submit a "Person in the Home Authoriza tion". • You must submit your application at least 60 days prior to providing care. Because a licensing inspection is required prior to providing care, it can sometimes take up to 90 days to get licensed. Applications are processed in the order they are received. Please plan accordingly. • For detailed application instructions, please view the Family Child Care Home Application Submission Guide on the Office of Early Childhood website (www.ColoradoOff iceofEa r lyChi l dho0d.com). Click the "For Providers" tab. Then select "Apply for a Child Care License." Select "Apply for a Family Child Care Homes License" and then select "Family Child Care Home Application Submission Guide". Section 1: General Application Information 1.1.) Please check ONE box for the type of home license you are applying for: Each family child care home license type has specific qualification requirements. See Rules Regulating Family Child Care Homes (7. 707) for more information. Please see the Licensing Fees Schedule to determine the appropriate license fee. Applications will be returned ff the correct fee is not included. lv l Family Child Care Home: 1-6 children □ Family Child Care □ Infant/Toddler □ Large Family D Experienced Home: 3 children Home Child Care Home: Child Care under 2 years 7-12 children Provider (ECCP)* *Experienced Child Care Provider Home license applicants must also submit the separate "ECCP Acknowledgement Form" IN ADDITION to this form. The ECCP license also requires special qualifications. 1.2) Please check the box for the reason you are submitting this application: If the reasons provided below do not apply to your request, please contact the Office of Early Childhood at 1.800.799.5876 or your licensing specialist for more information. Iv' !First time applying D Reapply (license D Change License D Change Physical wa s closed) Type/Capacity Property Address Revised: 7.3.2020 Page 1 of 6 D Add/Remove Applicant 2 (Spouse/ Other Adult who provides care) Child Care Licensing Family Child Care Home Origf nal License Application 1.3.) Applicant 1 Information -Required COLORADO Office of Early Childhood Division of Early Care & Learning This person lives in the home, cares for the children directly and is legally liable for the business. Be sure to complete the "Proo f of Law f ul Presence Affidavit" and submit a copy of legal identification with the application . First Name Middle Name Last Name Iliana Patricia Heikkila Social Security # Sex (M, F, X) Previous Last Name (if applicable) 454-81-7679 Female Cubias Phone Number Date of Birth (MM/DD/YYYY) Federal Tax ID (FEIN) 970-309-9423 05/20/1986 Email Address i-rami@hotmail.com 1.4) Applicant 2 In fo rmation -Required, if spouse/significant other lives in the home and provides care. This person lives in the home, provides care and is typically a spouse or significant other. This person is also legally liable for the business. This person must ALSO complete the "Proo f of Lawful Prese nce Affi davit " and submit a copy of legal identification with the application. First Name Middle Name Last Name Social Security # Sex (M, F, X) Previous Last Name (if applicable) Email Address Date of Birth (MM/DD/YYYY) If spouse/significant other lives in the home and will NOT be responsible for the care of children served, do not list them as Applicant #2 and please sign the acknowledgement b e low. lvl My spouse/significant other will NOT be directly responsible for the care and welfare of children served. Date 01/04/2021 1.5) Has either Applicant 1 or Applicant 2 ever applied for a child care license (of any type) in Colorado before? ~ No □ Yes. If yes, enter the information that appeared on the previous child care license application below. First Name (on previous application) Middle Name (on previous application) Last Name (on previous application) Date of Previous Application Previous License Number Previous Licen se Type Revised: 7 .3.2020 Page 2 of 6 Child Care Licensing Fam ily Chi ld Care Home Origina l License Application COLORADO Office of Early Childhood Division of Early Care & Learning Section 2: Provider Contact Information Required 2.1) Primary Residence/Physical Property Address (location where care will be provided) The primary residence (hom e) must be the location where the child care provider lives and will provide care. A license cannot be issued to a famHy child care home where the primary residence i s not the same location where care will be provided. Physical Stre e t Address City Zip Code County 12 River Boat Dr New Castle 81647 Garfield 2 .2) Directions for reaching your physical location (if necessary) 2. 3) Mailing address, if different than the physical property address provided above. If entered, this address will be used to send all official licensing correspondence. Mailing Street Address or P.O. Box City State Zip Code 2.4) Operating Information: Hours of Operation (select all that apply) Open:_8_:o_o ___ AM/PM Close: 4:30 AM/PM ----- Osun. lvl Mon . lvlTues. lvl Weds. ~ Thurs. ~Fri. □ Sat. Months of Operation [ se lect all that ~ly) ~Ja n ~Feb ~Mar v' Apr ~May ~Jun ~Jul ~Aug ~Sept ~Oct ~Nov0 Dec Section 3: People Living in the Home* Please PRINT tlie names of all people living in your home includjng your spouse/significant other, children, relatives, roommates, tenants, etc., regardless of age , EVEN IF THEY ARE NOT RELATED to you. Applications wilt be returned and processing will be delayed if we are unable to read your handwriting! # Name Previous Name Social Date of Birth Relationship to Sex (First, Last) (if applicable) Security# (MM/DD/YYYY) Applicant 1 (M , F, X) 1 Wryan Heikkila 521-91-1434 10/05/1993 Spouse M 2 Cristopher Ramirez 651-52-5509 12/15/2008 Child M 3 Elizabeth Heikkila 026-73-1462 10/06/2018 Child F 4 David Heikkila 825-75-1237 05/04/2020 Child M 5 6 7 8 *If there are more people living in your home than the space above allows, please print an additional copy of this page and submit the required information with your application. Revised: 7 .3.2020 Page 3 of 6 Child Care Licensing Family Child Care Hom e or;g;nal License Application Section 4: Child Abuse/Neglect Record Check Authorization COLORADO Office of Early Childhood Divi si on of Early Care & Learning Other tha n Applican t 1 and 2, are there any adults, over age 18, living in the home ? This includes, but is not limited to, a spouse, grandparents, aunts, uncles, children going to college, permanent substitutes, roommates, etc. ~No □Yes. If yes, everv adult living in the home (other than Applicant 1 and 2) MUST complete and sign the Background Investigation Authorization statement below. Bac kgro und Investigation Authorization* This authorization is ONLY required for adults, age 18 and older ONLY living in the home IV I I authorize the Colorado Department of Human Services (CDHS) to review my name with the State IV I child abuse and neglect database to obtain any reports of child abuse or neglect. I also authorize the Department to obtain child abuse and neglect reports every five years, as long as lv l I am listed on the child care license as living in the family child care home. Q I understand that as a person who is 18 years of age or older who resides in the family child care ~ home, I am required to submit a complete set of fingerprints to the Colorado Bureau of Investigation for a criminal check of CBI and FBI records. I understand that I must sign the Privacy Act Notification form prior to, or at the time of, being fingerprinted. ~~~~ltLi. D~e 01/04/2021 Iliana Patricia Heikkila *If more than one adult (other than Applicant 1 and 2) lives in the home, please print additional copies of this page and submit the required information with your application. Section 5: History of Criminal Record* Have you, anyone living with you, or anyo ne e mployed by you, been convicted or entered into a deferred sentence for ANY felony offense, ANY child abuse, or unlawful sexual be ha vior (in ANY state) before? 0 No O ves. If yes, enter the information for each person and conviction below. First Name Last Name Date of Birth (MM/DD/YYYY) Name at the time of conviction or deferred sentence, if different than above. Date of Conviction/Deferred Sentence Type of Conviction/Deferred Sentence City Conviction Occurred State Conviction Occurred County Conviction Occurred .. *If more than one person has a conviction OR if one person has several conv1ct1ons, please print add1t1ona l copies of this page and submit the required information with your application . Revised : 7.3 .2020 Page 4 of 6 Child Care Licensing Family Child Care Home Original License Application COLORADO Office of Early Childhood Division of Early Care & Learning Section 6: Application Acknowledgement Please check the boxes to the left of each statement below to indicate that both Applicant 1 and 2 agree. Both Applicant 1 and Applicant 2 must also sign the bottom of' this section in order to begin processing the application. The undersigned hereby applies for a license to operate a Family Care Home under 26-6-101 et seq . C.R.S. 2018 as amended, and certifies to the following facts. jvl I have read and am fully familiar with the licensing rules regulating family care homes and/or the general rules and regulations for child care facilities issued by the Colorado Department of Human Services (CDHS) and I agree to fully comply with them. I understand that until a license is issued, it is illegal for me to care for children other than specified in Statute or specifically listed under the exemptions in the general rules and regulations. I understand that before a child care license is issued, a licensing inspection must be completed. I agree to cooperate with the Department in its inspection to determine conformity with the regulations. I understand that if issued a child care license, it will designate the number and ages of children for which care may be given. Further, I understand that if I fail to maintain the rules and regulations, the license is subject to revocation. I authorize the Colorado Department of Human Services (CDHS) to run the child abuse and neglect check for all people listed as living in the family child care home, regardless of age, including myself. I authorize the Colorado Department of Human Services (CDHS) to obtain child abuse and neglect reports for all people listed on this application, regardless of age, upon initial licensure and every five years thereafter. I understand that the applicant(s) AND any person 18 years of age or older who resides in the family care home are required to submit a complete set of fingerprints to the Colorado Bureau of Investigation (CBI) for a criminal check of CBI and FBI records. I understand that those who require fingerprinting are responsible for paying for all fingerprinting costs. I understand that all adults who submit fingerprints for this license must sign the Privacy Act Notification prior to, or at the time of, being fingerprinted. I also understand the Privacy Act Notification must be maintained at the licensed child care home and made available to the Department upon request. I understand and authorize the Department to check the status of any fingerprints for people listed as living in the family child care home through the approved fingerprint vendor. I agree to adhere to the non-discrimination provisions of Title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975, the Rehabilitation Act of 1973, and Titles I through V of the Americans with Disabilities Act, as amended, and their implementation regulations which prohibit discrimination on the grounds of race, color, national origin, age, or disability. I understand that upon receipt by the Colorado Department of Human Services, this application becomes a public record. The responses I provide on this application are correct to the best of my ability. I understand that providing false information to the Colorado Department of Human Services could result in my being fined as much as $100 a day to a maximum of $10,000. Date 01/04/2021 Signature of Applicant 2 (Secondary Applicant) -REQUIRED, if spouse/significant other lives in home and Date provides care. Revised: 7.3.2020 Page 5 of 6 Child Care Licensing Family Child Care Home Original Ucense Application STOP! Before you submit your application: COLORADO Office of Early Childhood Division of Early Care & Learning • Did you type your application? If not, will the person who receives and processes the application be able to read what you wrote? Is your application complete? Applications will be returned and processing will be delayed if application is incomplete or we are unable to read your handwriting! • Did you include someone as Applicant 2 on the application? Did they sign Section 6? • Did you include a signed copy of the "Proof of Lawful Presence Affidavit" for BOTH Applicant 1 and Applicant 2(if applicable)? Two separate documents are required. • Did you include a copy of legal identification for BOTH Applicant 1 and Applicant 2(if applicable)? • Did you include a check for the correct licensing fee? Applications will be returned if the correct fee is not included. Please see the "Licensing Fees Schedule " to determine the appropriate license fee. Make check or money order payable to Colorado Department of Human Services (CDHS). • Are you applying for an Experienced Child Care Provider Home (ECCP) license? If so, did you include a completed "ECCP Acknowledqement Form"? • Mail ALL of your completed application materials to: Colorado Department of Human Services (CDHS) Office of Early Childhood (OEC) 1575 Sherman Street, First Floor Attn: Application Processing Denver, CO 80203-1714 If you have any questions, please call the Office of Early Childhood at 1.800. 799. 5876 or visit ColoradoOfficeofEarlyChildhood.com. Revised: 7.3.2020 Page 6 of 6 Certifications and Training Requirements from State obtained by Applicant HEARTSAVER Heartsaver@ First Aid CPR AED Iliana Heikkila American Heart Association . has successfully completed the cognitive and skills evaluations in accordance with the curriculum of the American Heart Association Heartsaver First Aid CPR AED Program. Optional modules completed: Issue Date 9/12/2020 Training Center Name Colorado ALS Training Center ID CO01359 Child CPR AED , Infant CPR Training Center City, State Denver, CO Training Center Phone Number (303) 255-2705 Renew By 09/2022 Instructor Name Vonda Williams Instructor ID 02060009715 eCard Code 206005553426 QR Code To view or verify authenticity, students and employers should scan this QR code with their mobile device or go lo www.heart.org/cpr/mycards. © 2020 American Heart Association. All rights reserved. 15-3002 R3/20 COLORA DO STA. -!:A l STAffT URO ~ AUll UB11 lll8m8 CERTIFICATE OF COMPL ETION Early Childhood Professional Development information System (POIS) This Certificate Ce rt ifi es that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 3.00 Clock Hours -Family Child Care Provider(CO) # Clock Hours 3 .00 Clock Hours for Part I: Medication Administration Training (MAT) Early Childhood Educator and Administrator Competencies -HSN07 Care plans., Level 2 -HSN07 Care plans., Level 3 -HSNOl Rules and regulations., Level I -HSNOl Rules and regulations., Level 2 -HSN04 Good health practices., Level l -HSN04 Good health practices., Level 2 -HSN07 Care plans., Level 1 This Friday, 16 October 2020 This certificate will expire: Monday, 16, October, 2023 Part II Face-to-Face Training Session This certificate of completion for MAT is not valid until Part II is completed . By signing this certificate, you certify the above named party has successfully compl~ted Part II, the 1 Clock Hour face-~o-face porpon of the Medication Administration Training. Facilitator Name (Print): k' <l? r JV ,;),;-,\hv[?u:(h/tCi"facilitator Signa~re:, ~J , {~U,-,t.. s.s~) Date of Completion: /f} / Z Z / Zc..) This cenilk:afl2 does lfOt CDIJStlli.&J a cMtf care llcsnse from tJre ~do ~ or Human 5ervk.es (CIHJS) I .I !COLORADO 1 !COLORADO C{J/-/C_ Department ol Edu caoon ~ Department of Human Setw::eS Skills, Delegation, & Supervision Checklist Medication Administration Approved training materials have been used in accordance with Colorado's Medication Administration Training for Unlicensed Asslstive Personnel in Public, Charter, Private and Parochial Schools, Child Care Centers, Preschools, School-Age Child Care, Residential Camps, Day Camps, and Family Child Care Homes, 2017, Sixth Edition . ,_ /,, / □NEW-Test Score:_____ Training Date: ldJ/1--4 ',,.2,,0;1() □ RENEW Staff Name: School/Child Care: Competency for Unlicensed Asslstlve Personnel Facilitator CCHC/SN CCHC/SN CCHC/SN <UAP) Initial & Date Initial & Date Initial & Date Initial & Date 1. Written Authorization: f@a(;!d r;..-, Parent Permission & Health Care Provider a. Authorization 'fl b. Health Care Plan (when needed) 2. Medication in pharmacy labeled bottle . t-1f~ 3. Follows proper medication storage 4. Definition of routine medications 5. Demonstration Procedure: a. Wash hands, put on gloves If Indicated /1$-b. Check written instructions with the label C. Identify child and follow 6 rights 1%¼ d. Prepare without touching medication e. Double check the label and medication log f, Observe and check child taking medication g. Document h. Trinle check label & return to secure storaoe 6. Oral (Pills, liquid, and controlled medications) J131%1/2 7. Topical (eve ear skin creams, ointments, and patches) 8. Severe Allergy/Anaphylaxis Medications , , a. Describes signs and symptoms /$ b. Identifies need for epinephrine vs. antihistamine ;~ C. Monitors for increased symptoms d. Demonstrates administration of epinephrine and antihistamine e. . Confirms Importance of EMS activation f. Indicates need for second dose of e □ine □hrine 9. Asthma and lrihafop Medications a. Describes signs and symptoms /1:; b: Identifies rieed for 'treatment c. Monitors for increased symptoms 1~/4o d. Demonstrates administration of inhaled medications e. Confirms importance of EMS activation f. Indicates need for additional dose 10. Documentation: Medication Log ~ 11. Medication Incident procedure 12. Medication disposal procedure ,r~~ 13. Process to locate CCHC/SN 14. StudenUchild confldentialilv Competency The above staff member has completed Medication I The above staff member has completed Medica tion Statement: Administration Training and demonstrated c_ompetency on Administration Training, demonstrated competency on the steps the steps checked above. checked above, and delegated the responsibility to adminis ter routine medications . . ]:::2"'l-~),.';k/ .m QQ!:lQISN Signal!.Jr~ sind Initial: Date: Delegation Au t~rization: I have been trained in proper administration of routine medications . I understand the need to maintain skills and be observed on an onqoinr; basis bv a Reaistered Nurse!Plwsloian. I have had the opportunity ro ask questions & received setisfaclorv answers. Delegates Signature: Date: Delegating CCHC/SN Signature: Date: Delegates Signature: Date : Delegating CCHC/SN Signature: Date; Delegatee Signature: Date: Delegating CCHC/SN Sign ature: Date: Colorado's Medicalion Adminisn·ation Training for Unlicensed Assistive Personnel in Public, Charter, Private and Parochial Schools, Child Care Centers, Preschools, School-Age Child Care, Residential Camps. Day Camps, and Family Child Care Homes, 9/2017, Sixth Edition COLORADO START EAP.1..'f START STRONG QUALITY EARLY UARNING CERTIFICATE OF COMPLETION Early Childhood Professional Development Information System {POIS) T his Certificate Certifies that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 1.50 Clock Hours -Family Child Care Provider(CO) # Clock Hours 1 . 50 Clock Hours for Prevention of Sudden Infant Death Syndrome (SIDS) and Use of Safe Sleep Practices Early Childhood Educator and Administrator Competencies -HSN01 Rules and regulations., Level 1 -HSN01 Rules and regulations., Level 2 -HSN10 Safety precautions., Level 1 -HSN10 Safety precautions., Level 2 This Monday, 28 September 2020 This cettificate does not constitute a chl!d car e iicense fro,n the Colorado Dep artrnent of l-tuman Se,1,,,ices (CDHS) ~It"~~ COLORADO ~ COLORADO ~ ~ Department of Education_, ~ Department of Human Services ****Please DO NOT upload this certificate to the POIS.**** This course completion will be automatically recorded and calculated towards your Early Childhood Professional Credential. COLORADO START EARLY START STRONG DUALITY EARLY LEARNING CE RTIFI CATE OF COMPLETION Early Childhood Professional Development Information System (POIS) This Certificate Certifies that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 2.00 Clock Hours -Family Child Care Provider(CO) # Clock Hours 2.00 Clock Hours for Recognition and Reporting of Child Abuse and Neglect Early Childhood Educator and Administrator Competencies -HSN13 Reporting abuse., Level 1 -HSN01 Rules and regulations., Level 1 This Wednesday, 9 September 2020 This certificate does not constitute a child care iicense fro,ri the Colorado Deparb;1ent of Human Services {CDHS) i/!'!!> COLORADO ~ COLORADO ~ ~ Department of Education~ ~ Department of Human Services ****Please DO NOT upload this certificate to the PDIS. *"** This course completion will be automatically recorded and calculated towards your Early Childhood Professional Credential. COLORADO START EARI..Y S T ART STR ON G OUlllTl EARll UAANIN& CERTIFICATE OF COMPLETION Early Childhood Professional Develo pment Infor mation System (PD IS) This Ce r tificate Certifies that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 1.00 Clock Hours -Family Child Care Provider(CO) # Clock Hours 1.00 Clock Hours for Preventing Shaken Baby Syndrome and Abusive Head Trauma Early Childhood Educator and Administrator Competencies -CGDL06 Risk and protective factors., Level 1 -FCP12 F amity networking., Level 1 -FCP02 Family input., Level 2 -FCP13 Community resources., Level 1 This Wednesday, 9 September 2020 T:71s certificate does not constitute a child care license frorn the Coiorado Departlnent of Human Services (CDHS) ~c.m~ COLORADO ~ COLORADO ~ ~ Department of Education ~ ~ Department of Human Services ****Please DO NOT upload this certificate to the POIS.**** This course completion will be automatically recorded and calculated towards your Early Childhood Professional Credential. COLORADO ... ST ART EARLY START STRONG QUAllll EARLY LHRNING CERTIFICATE OF COMPLETION Early Childhood Professional Development Information System (POIS) This Certificate Certifies that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 1.50 Clock Hours -Family Child Care Provider(CO) # Clock Hours 1. 50 Clock Hours for Child Care and Preschool Immunizations Early Childhood Educator and Administrator Competencies -HSN01 Rules and regulations., Level 1 -HSN01 Rules and regulations., Level 2 This Wednesday, 9 September 2020 This certificate is valid for one year after the above course completion date. This certificate does not constitute a child care license from the Colorado Department of Human Services (CDHS) ~el~ COLORADO ~ COLORADO ..-irt ~ Department of Educati on ..-irt ~ Department of Human Services COLORADO START E AR LY START STRONG llllA1lll EARLY LIARIING CERTIFICATE OF COMPLETION Early Childhood Professional Development Information System (PDIS) This certifies that ILIANA HEIKKILA Successfully completed and is awarded : 1.5 hours for Standard Precautions, including Prevention and Control of Infectious Diseases and Immunizations Early Childhood Educator and Administrator Competencies • HSNOS Required training., Level 2 -HSN01 Rules and regulations ., Level 1 This Thursday October 8 2020 This certificate will expire: Friday October 8 2021 This certificate of completion is valid upon completion of the training and when the learner's site specific exposure control plan has been reviewed, unless the learner is a Family Child Care Home provider without employees who is not required by OSHA to have an exposure control plan. I have reviewed the program's exposure control plan with this participant. Facilitator Signature and Date: ______________ _ Role (circle one): Director Child Care Health Consultant Trainer Other: _____ _ Thi.,· t:e!'tific:;te does not l.·on.~!ifl:te i!. :.:hi!d £:nr.; !icens~· from the Coloratla !)eptutment fl_f Hum;m Servfre:, (CDHS). This c:ertijici?fi: iJ Yalidfor trliinh:g c,mq;!etttd hetween 12/1 S/2Ul9 and l l/3 !l2fJZfJ. ****Please DO NOT upload this certificate to the PDIS. **** This course completion will be automatically recorded and calculated towards your Early Childhood Professional Credential. ~ COLORADO .all►-~ Office of Early Childhood -Division of Early Care & Leaming COLORADO S!AXT ~.tl..P.L\<' START STRONG QUAllTl EARLY l!lRMIN& CER T IF ICA T E OF COMPL ET I ON Early Childhood Professional Development Information System (POIS) This Certificate Certifies that ILIANA HEIKKILA Successfully completed and is awarded: Clock Hours 1.50 Clock Hours -Family Child Care Provider(CO) # Clock Hours 1. 50 Clock Hours for Prevention of Sudden Infant Death Syndrome (SIDS) and Use of Safe Sleep Practices Early Childhood Educator and Administrator Competencies -HSN01 Rules and regulations ., Level 1 -HSN01 Rules and regulations., Level 2 -HSN10 Safety precautions., Level 1 -HSN10 Safety precautions., Level 2 This Monday, 28 September 2020 This certificate d oes not co_;;stitute a child care iicense tram the Coiurado t?epartrnent o/ Hurnan Serv/c-::s (CDHS) COLORADO COLORADO Department of Education _ ~ Department of Human Services ****Please DO NOT upload this certificate to the POIS.**** This course completion will be automatically recorded and calculated towards your Early Childhood Professional Credential.