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PUBLIC UTILITY
USR-819
TRUCK EQUIPMENT
AND PARKING
USR-1718
PEREZ
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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 Phone 3e3 -&S7-e'3'IQ
Address 1 Sty u 3 R;oei, Ks kg C City rent L..‘,0 -115r--- State co Zip SoG,a i
2. Address or Location of Access
Section a-1 Township 3- Range Cc (Q Subdivision Block 34 Lot ( a
Weld County Road #: Uu.,.,ws aAt Side of Road Distance from nearest intersection
3. Is there an existing access(es) to the property? Yes t No
# of Accesses 1-
4. Proposed Use:
Permanent ®. Residential/Agricultural ❑ industrial
❑ Temporary 04 Subdivision O Commercial ❑ Other u5R -,
w*******************************a*********************************************«*************************************************•
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil & Gas
D.R. = Ditch Road
•A = House
= PSroposed Access
• = Existing Access
NT
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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