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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 F
RE#:
1. Applicant Name T,,tnne(
Address S) L tat 3�
�I
5/20/09
_re Hi)! 9w;34}- N; /other Case #:P
$c4rot A Hilt Phone 303.313(7-'f317
City G'yte State tr0 Zip1c35-1(p
2. Address or Location of Access Sa 662 LA."( R 3 riC co go s ) 6
Section 5 Township CJ- A/ RangekWil4Subdivision Block ---- LotA RE -O-13 R -r
Weld County Road #: 3 Side of Road Distance from nearest intersection iSOO -Pt
3. Is there an existing access(es) to the property? Yes x No
4. Proposed Use:
❑ Permanent ❑ Residential/Agricultural
❑ Temporary ❑ Subdivision
# of Accesses
❑ Industrial
„Sl Commercial ❑ Other
*******************_*********************************************************************************_************************
5. Site Sketch
Legend for Access Description:
AG = Agricultural
RES = Residential
O&G = Oil & Gas
D.R. = Ditch Road
O = House
= Shed
A = Proposed Access
• = Existing Access
Ni
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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