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2010-1927
AUG-04-2008 MON 03:41 PM WE' D COUNTY PLANNING FAX NO. 970 '04 6498 P, 02
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WELD COUNTY ROAD ACCESS INFORMATION SHEET
Weld County Department of Public Works
• 111 H St PO Box 758 Greeley CO 80632
Phone: (970) 356-4000 x3750 Fax: (970) 304-6497 Road File#: Date: / 1/2Gj
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RE# : Other Case#:
;le rift e /It <a66ua^ qyv - 79Y--‘313
1. Applicant Name ,9c hi2 7- A f!' N" Co/i('—'� .[ Phone
Address /9 913 « I 7 City,is ee v, lie State CO Zip re‘n
2. Address or Laa ation of Access C t / 7 O. e. ♦°N,V e. t f4 0," 4'H'y (o h
Section `� Township tJ1V Range 7W u_ 'vision �+�4i , Block Aid Lot .i- if
Weld County Road #: / 7 Side of Road weft' Distance from nearest intersection ray/e
3. Is there an existing access(es) to the property? Yes X No #of Accesses
4. Proposed Use:
❑ Permanent Residential/Agricultural ❑ Industrial
❑ Temporary ❑ Subdivision .Commercial ❑ Other
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5. Site Sketch I / /
6 Legend for Access Description: `t/ 14/77 (fl I_
AG = Agricultural
RES = Residential
O&G = Oil&Gas
D.R. = Ditch Road
0 = House
• = Proposed Access 4 -,..
A = Existing Access
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OFFICE USE ONLY:
Road ADT Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized ❑ Information Insufficient
Reviewed By: Title:
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