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GEC. i+ •N 0 7( ,7'-. it a ,x. `tip V a �yt�+ �� 1 a c a. • w w ill ill ill plvio„.. . .r. oik, ,.. .0;1,. .„1,,i,-.., , t_. - ' rf IV S' K I 0 K 0 V o K J 0 0 i 2 W W(� � O I O W 2 } 3 � � Z_ dy' W Q Z W O U W J T m ^Q fi l 3 = a o W W „c° ya\ O x 0 C 3 L.T. 3 W K K `I a a a a yr. yp 6p aO ap ap pp a a W '6 W a a a a a a a 3 a 4 • WELD COUNTY ROAD ACCESS INFORMATION SHEET • Road File#: Date: i/a Cho 10 RE#: Other Case#: Weld County Department of Public Works 111 H Street, P.O. Box 758, Greeley, Colorado 80632 r' Phone: (970 )356-4000, Ext. 3750 Fax: (970)304-6497 -� r, ti 1. Applicant Name Tien 13d I nt Phone 303-2511- q91 Address City State Zip 2. Address or Location of Access Section V• Township H Range /o I? Subdivision Sett,rc2Block Lot Weld County Road#: 3 Side of Road Lie s•fr Distance from nearest intersection 3. Is there an existing access(es)to the property? Yes No X #of Accesses 4. Proposed Use: El Permanent 0 Residential/Agricultural ❑ Industrial ❑ Temporary I11 Subdivision ❑ Commercial ❑ Other *********************.******................*....************...***************************..«******;***..***********....**... 5. Site Sketch Legend for Access Description: AG = Agricultural RES = Residential O&G = Oil&Gas D.R. = Ditch Road = House = Shed • O'_'1 C.c9war� N i ( rfle 3 E9i'4ts ***.....*.....*..*......*************** 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: • Hello