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I ai., \ A o I i \I Is \ \,or t %,\, P{ N \ gt , \\._--s-\- i ..1 : \ \\!.5 \ \LI 7 1 I \\ \gr \ ' "\\:.\\*: (C3 I I "N — \ \ \\\.1. .-1 \ I N \ \ \ \\ \ SE" ! 1 ' I \ \q I ) I 0 '''TVI 0 I t I \i W I I I I ' z I I r ...m..... ..... .....••• 33Vld £L1Y133dS ,n I 1 I 1 I u I • • • WELD COUNTY ROAD ACCESS INFORMATION SHEET Weld County Department of Public Works 111 H Street, P.O. Box 758, Greeley, Colorado 80632 Phone: (970)3564000,Ext. 3750 Fax: (970)304-6497 Road File#: Date: RE#: Other Case#: 1. Applicant Name UOM JQ i eS In C. Phone Address `}IZo Sf, c,4AA a (ctcc. I7I City Fr rieric.{C State (n Zip 8bS3O 2. Address or Location/ of Access Spe 4G-RN Tn(0.� ��" � tt[�(dµjho 6u(lrPoD Section (.4 Township 7 N Range (O81.✓ Subdivision ock 2a-7A Lot 27 31 4-1 Weld County Road#: Z-2— Side of Road .$ i- Distance from nearest intersection (boo �c4 WCI2 3. Is there an existing access to the property? Yes X No #of Accesses 1 4. Proposed Use: ❑ Permanent ['Residential/Agricultural ❑ Industrial ❑ Temporary gSubdivision ❑ Commercial ❑Other 5. Site Sketch Legend for Access Description: AG = Agricultural r v(j • RES = Residential Y Z"L O&G = Oil&Gas D.R. = Ditch Road n = House ()kitQ = Shed ur Q = Proposed Access 'F 5:k = Existing Access WOt OFFICE USE ONLY: Road ADT Date Accidents Date Road ADT Date Accidents Date Drainage Requirement Culvert Size I ength Special Conditions ❑ Installation Authorized ❑ Information Insufficient Reviewed By: Title: • -7- Hello