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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 November
Road File#: Date:
RE#: Other Case#:
1. Applicant Name Danial L frhanen Phone 970-381 -3881
Address 18905 wcr 394 CityLa Salle Staten) Zip 80645
2. Address or Location of Access 1 71 64 I 2 5 access road
Section 2 Township 3N Range 68W6phSubdivisiol Block Lot
Weld County Road#:sorvi re rdSide of RoadwrR 3 F Distance from nearest intersection on in
3. Is there an existing access(es)to the property? Yes X No #of Accesses - 9 _
4. Proposed Use:
U Permanent Residential/Agricultural U Industrial
❑ Temporary U Subdivision Si Commercial U Other_
*******************************iii************************************t***************************qtr************************t*
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential ______I L_
O&G = Oil&Gas
D.R. = Ditch Road
O = House tt(
•O = Shed �l
c
= Proposed Access
A = Existing Access n
Ni •
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7 7
****...******....******.*******,*******
OFFICE USE ONLY:
Road ADT
Date Accidents Date
Road ADT Date Accidents Date
Drainage Requirement Culvert Size Length
Special Conditions
❑ Installation Authorized U Information Insufficient
Reviewed By: Title:
•
-9-
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