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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 #:
RE #:
1. Applicant Name )J -en c-S“..Cdo yn`c Phone3d3-&33 -5-75 2..
Address 77 lib tut e / c / City p% G.. p itch State GO Zip ;(,:7e L 1
2. Address or Location of Access 7 7 Lilo cc) C /c.' PD. Ltp -t r (<O‘,21
Section 7 Towcjhip 2 Range �? Subdivision Block L9t 4
Weld County Road #: /7 Side of Road G 4 51- Distance from nearest intersection /2 rn
3. Is there an existing access(es) to the property? Yes )C No # of Accesses /
Date:
Other Case #:
4. Proposed Use:
—Permanent ❑ Residential/Agricultural U Industrial
U Temporary ❑ Subdivision U Commercial ❑ Other
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil & Gas
D.R. = Ditch Road
O = House
O = Shed
A = Proposed Access
= Existing Access
NT
WC n 1`S
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:
-9-
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