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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:
RE # : Other Case #:
1. Applicant Name Nt6N NLA,Ns DKr eslL1 t c. Phone C8ia) Nld-4780
Address 6ol S. MAINSI0.Err sore tLs City G .npcu tic State -rx Zip Cosi
2. Address or Location of Access la a Sa wcq 32 ; 119 30 tWce 31 PLIS €ui«t Cot.ou.Ana
Section Z-`1 Township 3 Range cc Subdivision — Block — Lot —
Weld County Road #: 32 Side of Road soy rtl Distance from nearest intersection qas Ft
3. Is there an existing access(es) to the property? Yes / No # of Accesses I
4. Proposed Use:
to Permanent 0 Residential/Agricultural 0 Industrial
0 Temporary 0 Subdivision 0 Commercial 0 Other
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil & Gas
D.R. = Ditch Road
= House
0 = Shed
= Proposed Access
• = Existing Access
OFFICE USE ONLY:
Road ADT
Date Accidents
Road ADT
Drainage Requirement
Special Conditions
Date
Date
Culvert
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3
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vact 27.
SITE d;6
0
0i6
Accidents
Size
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3
Date
Length
Reviewed By:
0 Installation Authorized 0 Information Insufficient
Title:
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