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'Y,• : i.S 'E�• t Rs}�Sii eN: "kY 3a4tI v.s. 's- n 'Rr . } 'ti tr % a ->„, {h • ,;.,,fi . t t 5 yx qC i :II ll 2I• I i i) r, ii `t' � 1 �11 i „E , ' Ial EE ``, i#i" Ii i i UUE f i ii i ll I b j1 x X. X X OC (-n :lic- ,1 lik ter. 11 r 9111 a W 111 `� • .Y x�.•— a 1 2l `. • 1 n eQQ 3i at ICI 3 1 ,c.,.s.r- , ©r' I 3 t _ © amw .k OI B4 ' i .nne.p W.+i _ s i). _. .13 .53! : 3 } a a lib WELD COUNTY ROAD ACCESS INFORMATION SHEET . Weld County Department of Public Works 111 H Street, P.O. Box 758, Greeley, Colorado 80632 Phone: (970 )356-4000, Ext. 3750 Fax: (970)304-6497 Road File#: -- Date: RE#: Other Case#: 1. Applicant Name VICKI Vi.R5bt) Phone 970 -737- 22/9 Address 15544 WEkD Co RD co City PLATTEVI/J F State Co Zip Co6S/ 2. Address or Location of Access 155 y q CJ E L D Co RD 4 o Section Township Range Subdivision Block Lot Weld County Road#: 4'o Side of Road Sou y 4 Distance from nearest intersection %a m I LE 3. Is there an existing access(es)to the property? Yes ✓ No #of Accesses _ 4. Proposed Use: a. Permanent t /Residential/Agricultural ❑ Industrial J Temporary ❑ Subdivision ❑ Commercial ❑ Other 5. Site Sketch Legend for Access Description: AG = Agricultural _I L_ RES = Residential • O&G = Oil&Gas hi D.R. = Ditch Road 0 = House O = Shed A = Proposed Access �„ • A - = Existing Access I NT 7 F31-1 t *************************************** OFFICE USE ONLY: Road ADT Date Accidents Date Road ADT Date Accidents Date Drainage Requirement Culvert Size Length Special Conditions ❑ Installation Authorized ❑ Information Insufficient ipReviewed By: Title: -9- Hello