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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 C..owe.At70 .:lJ T e251 (.,;f\ -et• (...0n&2f . i Phone 970 ) 7 - S-24 i
Address 705!057 HYJY 59-,, City CArza state ('t) zip docc i 2
2. Address or Location of Access !o5lFE7 k Lip -7185, 2 -4,2 -f2 -,L OCoaa.Do 8 DLc / 2 - &1ELD J
,
Section 5 Township ! I i-4 Range v✓Subdivision Block Lot
Weld County Road #: Side of Road `T Distance from nearest intersection i a i Lo72
o; vJCa 4:. ! 6`O
3. Is there an existing access(es) to the property? Yes ✓ No # of Accesses c.tiE (i)
4. Proposed Use:
al —Permanent ❑ Residential/Agricultural industrial
❑ Temporary ❑ Subdivision ❑ Commercial ❑ Other
*********************************Yf**********************Irk ********************************************************************
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil & Gas
D.R. = Ditch Road
= House
O = Shed
= Proposed Access
• = Existing Access
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-PLANT ACC ere
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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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